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. 2021 Sep;29(9):2976-2986.
doi: 10.1007/s00167-020-06336-3. Epub 2020 Oct 26.

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

Jorge Chahla  1 , Kyle N Kunze  2 , Robert F LaPrade  3 , Alan Getgood  4 , Moises Cohen  5 , Pablo Gelber  6   7 , Björn Barenius  8 , Nicolas Pujol  9   10 , Manual Leyes  11 , Ralph Akoto  12 , Brett Fritsch  13 , Fabrizio Margheritini  14 , Leho Rips  15 , Jakub Kautzner  16 , Victoria Duthon  17 , Danilo Togninalli  18 , Zanon Giacamo  19 , Nicolas Graveleau  20 , Stefano Zaffagnini  21 , Lars Engbretsen  22 , Martin Lind  23 , Rodrigo Maestu  24 , Richard Von Bormann  25 , Charles Brown  26 , Silvio Villascusa  27 , Juan Carlos Monllau  28 , Gonzalo Ferrer  29 , Jacques Menetrey  17 , Michael Hantes  30 , David Parker  13 , Timothy Lording  31 , Kristian Samuelsson  32   33 , Andreas Weiler  34 , Soshi Uchida  35 , Karl Heinz Frosch  36   37 , James Robinson  26   38
Affiliations

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

Jorge Chahla et al. Knee Surg Sports Traumatol Arthrosc. 2021 Sep.

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: Delphi; Diagnosis; Knee; Medial collateral ligament; Posteromedial corner; Treatment.

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Conflict of interest statement

The authors declare no conflict of interest in relation to the subject of work.

Figures

Fig. 1
Fig. 1
Flow diagram of consensus process
Fig. 2
Fig. 2
Stacked leaning bar chart representing breakdown in agreement levels in the third round Delphi survey. Bars to the left of the Y axis indicate disagreement with bars to the right indicating agreement
See this image and copyright information in PMC

References

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