Posterolateral corner of the knee: an expert consensus statement on diagnosis, classification, treatment, and rehabilitation

Abstract

Purpose

To develop a statement on the diagnosis, classification, treatment, and rehabilitation concepts of posterolateral corner (PLC) injuries of the knee using a modified Delphi technique.

Methods

A working group of three individuals generated a list of statements relating to the diagnosis, classification, treatment, and rehabilitation of PLC injuries to form the basis of an initial survey for rating by an international group of experts. The PLC expert group (composed of 27 experts throughout the world) was surveyed on three occasions to establish consensus on the inclusion/exclusion of each item. In addition to rating agreement, experts were invited to propose further items for inclusion or to suggest modifications of existing items at each round. Pre-defined criteria were used to refine item lists after each survey. Statements reaching consensus in round three were included within the final consensus document.

Results

Twenty-seven experts (100% response rate) completed three rounds of surveys. After three rounds, 29 items achieved consensus with over 75% agreement and less than 5% disagreement. Consensus was reached in 92% of the statements relating to diagnosis of PLC injuries, 100% relating to classification, 70% relating to treatment and in 88% of items relating to rehabilitation statements, with an overall consensus of 81%.

Conclusions

This study has established a consensus statement relating to the diagnosis, classification, treatment, and rehabilitation of PLC injuries. Further research is needed to develop updated classification systems, and better understand the role of non-invasive and minimally invasive approaches along with standardized rehabilitation protocols.

Level of evidence

Consensus of expert opinion, Level V.

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Funding

No external funding was used.

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Corresponding author

Correspondence to Jorge Chahla.

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Conflict of interest

P.E.G. receives board membership fees from the Spanish Arthro- scopic Association and consultancy fees from Conmed; and is an employee of Hospital Sant Pau, Barcelona, Spain. The rest of the authors have nothing to disclose.

Ethical Approval

This study does not contain any studies with human participants performed by any of the authors.

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Chahla, J., Murray, I.R., Robinson, J. et al. Posterolateral corner of the knee: an expert consensus statement on diagnosis, classification, treatment, and rehabilitation. Knee Surg Sports Traumatol Arthrosc 27, 2520–2529 (2019). https://doi.org/10.1007/s00167-018-5260-4

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Keywords

  • Posterolateral corner
  • Knee
  • Expert
  • Consensus
  • Lateral collateral ligament
  • Popliteus
  • Reconstruction