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

• Published in: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA Vol. 27; no. 8; pp. 2520 - 2529
• Main Authors: Chahla, Jorge, Murray, Iain R., Robinson, James, Lagae, Koen, Margheritini, Fabrizio, Fritsch, Brett, Leyes, Manuel, Barenius, Björn, Pujol, Nicolas, Engebretsen, Lars, Lind, Martin, Cohen, Moises, Maestu, Rodrigo, Getgood, Alan, Ferrer, Gonzalo, Villascusa, Silvio, Uchida, Soshi, Levy, Bruce A., Von Bormann, Richard, Brown, Charles, Menetrey, Jacques, Hantes, Michael, Lording, Timothy, Samuelsson, Kristian, Frosch, Karl Heinz, Monllau, Juan Carlos, Parker, David, LaPrade, Robert F., Gelber, Pablo E.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-08-2019; Springer Nature B.V
• Subjects: Classification; Classification systems; Consensus; Delphi method; Diagnosis; Expert; Experts; fibular collateral ligament; Injuries; Knee; Lateral collateral ligament; Medical diagnosis; Medicin och hälsovetenskap; Medicine; Medicine & Public Health; Orthopedics; Ortopedi; outcomes; Polls & surveys; Popliteus; Posterolateral corner; Reconstruction; Rehabilitation; repair; Sport Sciences; Surgery; surgical-treatment; Upgrading; Knee; Reconstruction; Posterolateral corner; Lateral collateral ligament; Popliteus; Expert; Consensus
• ISSN: 0942-2056; 1433-7347; 1433-7347
• DOI: 10.1007/s00167-018-5260-4

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.