Bone and Joint Institute

Title

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

Authors

Jorge Chahla, Rush University Medical Center
Kyle N. Kunze, Hospital for Special Surgery - New York
Robert F. LaPrade, Twin Cities Orthopaedics
Alan Getgood, Fowler Kennedy Sport Medicine Clinic
Moises Cohen, Universidade Federal de Sao Paulo
Pablo Gelber, Universitat Autònoma de Barcelona
Björn Barenius, South Hospital Stockholm
Nicolas Pujol, CHV Centre Hospitalier de Versailles
Manual Leyes, Clínica CEMTRO
Ralph Akoto, Asklepios Klinik St. Georg
Brett Fritsch, Sydney Orthopaedic Research Institute
Fabrizio Margheritini, Università degli Studi di Roma "Foro Italico"
Leho Rips, Tartu Ülikooli Kliinikum
Jakub Kautzner, Fakultní Nemocnice v Motole
Victoria Duthon, Hôpitaux universitaires de Genève
Danilo Togninalli, Ars Ortopedica
Zanon Giacamo, Università degli Studi di Pavia
Nicolas Graveleau, Clinique du Sport de Bordeaux
Stefano Zaffagnini, IRCCS Rizzoli Orthopaedic Institute, Bologna
Lars Engbretsen, Oslo Sports Trauma Research Center
Martin Lind, Aarhus Universitetshospital
Rodrigo Maestu, Centro de tratamiento de enfermedades articulares
Richard Von Bormann, Cape Town Sports & Orthopaedic Clinic
Charles Brown, International Knee and Joint Centre
Silvio Villascusa, Hospital la Fraternidad
Juan Carlos Monllau, Universitat Autònoma de Barcelona
Gonzalo Ferrer, Hospital Clínico de la Mutual de Seguridad C.Ch.C
Jacques Menetrey, Hôpitaux universitaires de Genève
Michael Hantes, Panepistimio Thesalias
David Parker, Sydney Orthopaedic Research Institute
Timothy Lording, Melbourne Orthopaedic Group
Kristian Samuelsson, Sahlgrenska Universitetssjukhuset
Andreas Weiler, Zentrum für Spezielle Gelenkchirurgie

Document Type

Article

Publication Date

1-1-2020

Journal

Knee Surgery, Sports Traumatology, Arthroscopy

URL with Digital Object Identifier

10.1007/s00167-020-06336-3

Abstract

© 2020, European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA). 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.

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