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Large variability exists in the management of posterolateral corner injuries in the global surgical community

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

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.

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Funding

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Sant Quintí, 89-08041, Barcelona, Spain

    Pablo Eduardo Gelber

  2. ICATME-Institut Universitari Dexeus, Universitat Autònoma de Barcelona, Barcelona, Spain

    Pablo Eduardo Gelber

  3. Division of Sports Medicine, Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA

    Justin Drager, Bhargavi Maheshwer & Jorge Chahla

  4. Clínica CEMTRO, Madrid, Spain

    Manuel Leyes

  5. Stockholm South Hospital, Karolinska Institutet, Stockholm, Sweden

    Björn Barenius

  6. Avon Orthopaedic Centre, Bristol, UK

    James Robinson

  7. Centre Hospitalier de Versailles, Le Chesnay, France

    Nicolas Pujol

  8. University of Rostock, Rostock, Germany

    Thomas Tischer

  9. University of Rome Foro Italico, Rome, Italy

    Fabrizio Margheritini

  10. Sydney Orthopaedic Research Institute, Sydney, Australia

    Brett Fritsch

  11. University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Karl-Heinz Frosh

  12. Rush University Medical Center, Chicago, USA

    Jorge Chahla

Authors
  1. Pablo Eduardo Gelber
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  2. Justin Drager
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  12. Jorge Chahla
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Correspondence to Pablo Eduardo Gelber.

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Gelber, P.E., Drager, J., Maheshwer, B. et al. Large variability exists in the management of posterolateral corner injuries in the global surgical community. Knee Surg Sports Traumatol Arthrosc 28, 2116–2123 (2020). https://doi.org/10.1007/s00167-020-05922-9

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  • DOI: https://doi.org/10.1007/s00167-020-05922-9

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