The posteromedial corner of the knee: an international expert consensus statement on diagnosis, classification, treatmen
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The posteromedial corner of the knee: an international expert consensus statement on diagnosis, classification, treatment, and rehabilitation Jorge Chahla1 · Kyle N. Kunze2 · Robert F. LaPrade3 · Alan Getgood4 · Moises Cohen5 · Pablo Gelber6,7 · Björn Barenius8 · Nicolas Pujol9,10 · Manual Leyes11 · Ralph Akoto12 · Brett Fritsch13 · Fabrizio Margheritini14 · Leho Rips15 · Jakub Kautzner16 · Victoria Duthon17 · Danilo Togninalli18 · Zanon Giacamo19 · Nicolas Graveleau20 · Stefano Zaffagnini21 · Lars Engbretsen22 · Martin Lind23 · Rodrigo Maestu24 · Richard Von Bormann25 · Charles Brown26 · Silvio Villascusa27 · Juan Carlos Monllau28 · Gonzalo Ferrer29 · Jacques Menetrey17 · Michael Hantes30 · David Parker13 · Timothy Lording31 · Kristian Samuelsson32,33 · Andreas Weiler34 · Soshi Uchida35 · Karl Heinz Frosch36,37 · James Robinson26,38 Received: 26 August 2020 / Accepted: 13 October 2020 © European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2020
Abstract Purpose To establish recommendations for diagnosis, classification, treatment, and rehabilitation of posteromedial corner (PMC) knee injuries using a modified Delphi technique. Methods A list of statements concerning the diagnosis, classification, treatment and rehabilitation of PMC injuries was created by a working group of four individuals. Using a modified Delphi technique, a group of 35 surgeons with expertise in PMC injuries was surveyed, on three occasions, to establish consensus on the inclusion or exclusion of each statement. Experts were encouraged to propose further suggestions or modifications following each round. Pre-defined criteria were used to refine item lists after each survey. The final document included statements reaching consensus in round three. Results Thirty-five experts had a 100% response rate for all three rounds. A total of 53 items achieved over 75% consensus. The overall rate of consensus was 82.8%. Statements pertaining to PMC reconstruction and those regarding the treatment of combined cruciate and PMC injuries reached 100% consensus. Consensus was reached for 85.7% of the statements on anatomy of the PMC, 90% for those relating to diagnosis, 70% relating to classification, 64.3% relating to the treatment of isolated PMC injuries, and 83.3% relating to rehabilitation after PMC reconstruction. Conclusion A modified Delphi technique was applied to generate an expert consensus statement concerning the diagnosis, classification, treatment, and rehabilitation practices for PMC injuries of the knee with high levels of expert agreement. Though the majority of statements pertaining to anatomy, diagnosis, and rehabilitation reached consensus, there remains inconsistency as to the optimal approach to treating isolated PMC injuries. Additionally, there is a need for improved PMC injury classification. Level of evidence Level V. Keywords Posteromedial corner · Knee · Diagnosis · Treatment · Delphi · Medial collateral ligament
Introduction
* Jorge Chahla [email protected] Extended author information available
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