Jorge Chahla1, Iain R Murray2, James Robinson3,4, Koen Lagae5, Fabrizio Margheritini6, Brett Fritsch7, Manuel Leyes8, Björn Barenius9, Nicolas Pujol10,11, Lars Engebretsen12, Martin Lind13, Moises Cohen14, Rodrigo Maestu15, Alan Getgood16, Gonzalo Ferrer17, Silvio Villascusa18, Soshi Uchida19, Bruce A Levy20, Richard Von Bormann21, Charles Brown22, Jacques Menetrey23, Michael Hantes24, Timothy Lording25, Kristian Samuelsson26,27, Karl Heinz Frosch28,29, Juan Carlos Monllau30, David Parker7, Robert F LaPrade31, Pablo E Gelber32,33. 1. Rush University Medical Center, 1611 W Harrison, Suite 300, Chicago, IL, 60612, USA. jachahla@msn.com. 2. Department of Orthopaedic Surgery, The University of Edinburgh, Edinburgh, UK. 3. Avon Orthopaedic Centre, Bristol, UK. 4. International Knee and Joint Center, Abu Dhabi, UAE. 5. Monica Hospitals, Antwerp, Belgium. 6. University of Rome Foro Italico, Rome, Italy. 7. Sydney Orthopaedic Research Institute, Sydney, Australia. 8. Clínica CEMTRO, Madrid, Spain. 9. Stockholm South Hospital, Karolinska Institutet, Stockholm, Sweden. 10. Centre Hospitalier de Versailles, Le Chesnay, France. 11. Oslo University Hospital, Oslo, Norway. 12. Oslo Sports Trauma Research Center, Oslo, Norway. 13. Aarhus University Hospital, Aarhus, Denmark. 14. Universidade Federal de São Paulo, São Paulo, SP, Brazil. 15. Centro de tratamiento de enfermedades articulares, Buenos Aires, Argentina. 16. Fowler Kennedy Sports Medicine Clinic, London, ON, Canada. 17. Hospital Clinico Mutual de Seguridad, Santiago, Chile. 18. Hospital La Fraternidad Habana, Madrid, Spain. 19. Wakamatsu Hospital for the University of Occupational and Environmental Health, Kitakyushu, Japan. 20. Mayo Clinic, Rochester, MN, USA. 21. Cape Town Sports & Orthopaedic Clinic, Cape Town, South Africa. 22. International Knee and Joint Centre, Abu Dhabi, UAE. 23. University Hospitals of Geneva, Geneva, Switzerland. 24. University of Thessalia, Larissa, Greece. 25. Melbourne Orthopaedic Group, Melbourne, Australia. 26. Department of Orthopaedics, Sahlgrenska University Hospital, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden. 27. Nanometer Structure Consortium, Lund University, Lund, Sweden. 28. University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 29. Asklepios Clinic St. Georg, Hamburg, Germany. 30. Parc de Salut Mar, UAB, Barcelona, Spain. 31. The Steadman Clinic, Vail, CO, USA. 32. Department of Orthopaedic Surgery, Hospital de la Sta Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain. 33. ICATME-Hospital Universitari Dexeus, Universitat Autònoma de Barcelona, Barcelona, Spain.
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.
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.
Authors: Jorge Chahla; Betina B Hinckel; Adam B Yanke; Jack Farr; William D Bugbee; James L Carey; Brian J Cole; Dennis C Crawford; James E Fleischli; Alan Getgood; Andreas H Gomoll; Simon Gortz; Allan E Gross; Deryk G Jones; Aaron J Krych; Christian Lattermann; Bert R Mandelbaum; Peter R Mandt; Tom Minas; Raffy Mirzayan; Timothy S Mologne; John D Polousky; Matthew T Provencher; Scott A Rodeo; Oleg Safir; Seth Lawrence Sherman; Eric D Strauss; Sabrina M Strickland; Christopher J Wahl; Riley J Williams Journal: Orthop J Sports Med Date: 2020-03-26
Authors: Jonatas Brito de Alencar Neto; Clodoaldo José Duarte de Souza; Márcio Bezerra Gadelha Lopes; Maria Luzete Costa Cavalcante; Luiz Holanda Pinto Neto Journal: Case Rep Orthop Date: 2020-07-14
Authors: Philipp W Winkler; Bálint Zsidai; Nyaluma N Wagala; Jonathan D Hughes; Alexandra Horvath; Eric Hamrin Senorski; Kristian Samuelsson; Volker Musahl Journal: Knee Surg Sports Traumatol Arthrosc Date: 2020-11-17 Impact factor: 4.342