Andreas Weiler1, Karl-Heinz Frosch2, Clemens Gwinner3, Michael J Strobel4, Philipp Lobenhoffer5. 1. Sporthopaedicum Berlin, Bismarckstraße 45-47, 10627, Berlin, Germany. weiler@arthroskopie.de. 2. Department of Trauma, Hand and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 3. Center for Musculoskeletal Surgery, Charité-University Medicine Berlin, Berlin, Germany. 4. Sporthopaedicum Straubing, Straubing, Germany. 5. Gelenkchirurgie Orthopädie Hannover, Hannover, Germany.
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.
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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