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The Posterolateral Instability Score (PoLIS) of the knee joint: a guideline for standardized documentation, classification, and surgical decision-making

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

There has been a recent resurgence in interest in posterolateral instabilities of the knee joint. As this terminology comprises a large variety of pathologies, confusion and ambiguity in communication between surgeons and allied health professionals are generated. Consequently, accurate classification criteria are required to account for thorough preoperative diagnostics, surgical decision-making, and a standardized scientific documentation of injury severity.

Methods

A working group of five knee surgeons, who retrospect more than 2000 reconstructions of the posterolateral corner (PLC) at the minimum, was founded. An advanced PubMed search was conducted to identify key definitions. After defining an accurate diagnostic work-up, popular consensus was reached on definitions and covariates for a novel classification, rating of injury severity, and the resulting surgical decision-making.

Results

Three columns (lateral instability, cruciate ligament involvement, and relevant covariates), each ranging from A to D with increasing severity and assigning a number of points, were needed to meet the requirements. The generated terminology translated into the Posterolateral Instability Score (PoLIS) and the added number of points, ranging from 1 to 18, depicted the injury severity score.

Conclusion

The presented classification may enable an objective assessment and documentation of the injury severity of the inherently complex pathology of injuries to the lateral side of the knee joint.

Level of evidence

V.

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Funding

No funding related to this study was received by any of the authors.

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Authors and Affiliations

  1. Sporthopaedicum Berlin, Bismarckstraße 45-47, 10627, Berlin, Germany

    Andreas Weiler

  2. Department of Trauma, Hand and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Karl-Heinz Frosch

  3. Center for Musculoskeletal Surgery, Charité-University Medicine Berlin, Berlin, Germany

    Clemens Gwinner

  4. Sporthopaedicum Straubing, Straubing, Germany

    Michael J. Strobel

  5. Gelenkchirurgie Orthopädie Hannover, Hannover, Germany

    Philipp Lobenhoffer

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  1. Andreas Weiler
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  2. Karl-Heinz Frosch
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  3. Clemens Gwinner
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  4. Michael J. Strobel
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  5. Philipp Lobenhoffer
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All authors have seen and approved submission of the manuscript, and have taken due care to ensure the integrity of the work. According to the "Uniform requirements for manuscripts submitted to biomedical journals", all authors have contributed significantly to the study.

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Correspondence to Andreas Weiler.

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Weiler, A., Frosch, KH., Gwinner, C. et al. The Posterolateral Instability Score (PoLIS) of the knee joint: a guideline for standardized documentation, classification, and surgical decision-making. Knee Surg Sports Traumatol Arthrosc 29, 889–899 (2021). https://doi.org/10.1007/s00167-020-06044-y

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  • DOI: https://doi.org/10.1007/s00167-020-06044-y

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