Pablo Eduardo Gelber1,2, Justin Drager3, Bhargavi Maheshwer3, Manuel Leyes4, Björn Barenius5, James Robinson6, Nicolas Pujol7, Thomas Tischer8, Fabrizio Margheritini9, Brett Fritsch10, Karl-Heinz Frosh11, Jorge Chahla3,12. 1. Department of Orthopaedic Surgery, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Sant Quintí, 89-08041, Barcelona, Spain. personal@gmail.com. 2. ICATME-Institut Universitari Dexeus, Universitat Autònoma de Barcelona, Barcelona, Spain. personal@gmail.com. 3. Division of Sports Medicine, Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA. 4. Clínica CEMTRO, Madrid, Spain. 5. Stockholm South Hospital, Karolinska Institutet, Stockholm, Sweden. 6. Avon Orthopaedic Centre, Bristol, UK. 7. Centre Hospitalier de Versailles, Le Chesnay, France. 8. University of Rostock, Rostock, Germany. 9. University of Rome Foro Italico, Rome, Italy. 10. Sydney Orthopaedic Research Institute, Sydney, Australia. 11. University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 12. Rush University Medical Center, Chicago, USA.
Abstract
PURPOSE: The management of posterolateral corner (PLC) injuries has significantly evolved over the past 2 decades. The purpose of this study was to determine the current worldview of key concepts on the diagnosis, treatment strategy, and rehabilitation for patients presenting with PLC injuries. METHODS: A 12-question multiple-choice online survey was designed to address key questions in the diagnosis, treatment, and rehabilitation of PLC injuries. The survey was distributed to the most important international sports medicine societies worldwide. Clinical agreement was defined as > 80% of agreement in responses and general agreement was defined as > 60% of agreement in responses. RESULTS: 975 surgeons completed the survey with 49% from Europe, 21% from North America, 12% from Latin America, 12% from Asia, and smaller percentages from Africa and Oceania. Less than 14% of respondents manage more than ten PCL injuries yearly. Clinical agreement of > 80% was only evident in the use of MRI in the diagnosis of PLC injury. Responses for surgical treatment were split between isometric fibular-based reconstruction techniques and anatomically based fibular and tibial-based reconstructions. A general agreement of > 60% was present for the use of a post-operative brace in the early rehabilitation. CONCLUSION: In the global surgical community, there remains a significant variability in the diagnosis, treatment, and postoperative management of PLC injuries. The number of PLC injuries treated yearly by most surgeons remains low. As global clinical consensus for PLC remains elusive, societies will need to play an important role in the dissemination of evidence-based practices for PLC injuries. LEVEL OF EVIDENCE: IV.
PURPOSE: The management of posterolateral corner (PLC) injuries has significantly evolved over the past 2 decades. The purpose of this study was to determine the current worldview of key concepts on the diagnosis, treatment strategy, and rehabilitation for patients presenting with PLC injuries. METHODS: A 12-question multiple-choice online survey was designed to address key questions in the diagnosis, treatment, and rehabilitation of PLC injuries. The survey was distributed to the most important international sports medicine societies worldwide. Clinical agreement was defined as > 80% of agreement in responses and general agreement was defined as > 60% of agreement in responses. RESULTS: 975 surgeons completed the survey with 49% from Europe, 21% from North America, 12% from Latin America, 12% from Asia, and smaller percentages from Africa and Oceania. Less than 14% of respondents manage more than ten PCL injuries yearly. Clinical agreement of > 80% was only evident in the use of MRI in the diagnosis of PLC injury. Responses for surgical treatment were split between isometric fibular-based reconstruction techniques and anatomically based fibular and tibial-based reconstructions. A general agreement of > 60% was present for the use of a post-operative brace in the early rehabilitation. CONCLUSION: In the global surgical community, there remains a significant variability in the diagnosis, treatment, and postoperative management of PLC injuries. The number of PLC injuries treated yearly by most surgeons remains low. As global clinical consensus for PLC remains elusive, societies will need to play an important role in the dissemination of evidence-based practices for PLC injuries. LEVEL OF EVIDENCE: IV.
Entities:
Keywords:
Management; Posterolateral corner injury; Survey study
Authors: Bhargavi Maheshwer; Kevin C Parvaresh; Brady T Williams; Evan M Polce; Daniel Schloss; Jorge Chahla Journal: JBJS Essent Surg Tech Date: 2022-01-07
Authors: Julian Stürznickel; Felix N Schmidt; Conradin Schweizer; Herbert Mushumba; Matthias Krause; Klaus Püschel; Tim Rolvien Journal: Orthop J Sports Med Date: 2022-09-28