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

TY - JOUR

T1 - Large variability exists in the management of posterolateral corner injuries in the global surgical community

AU - Gelber, Pablo Eduardo

AU - Drager, Justin

AU - Maheshwer, Bhargavi

AU - Leyes, Manuel

AU - Barenius, Björn

AU - Robinson, James

AU - Pujol, Nicolas

AU - Tischer, Thomas

AU - Margheritini, Fabrizio

AU - Fritsch, Brett

AU - Frosch, Karl-Heinz

AU - Chahla, Jorge

PY - 2020/7

Y1 - 2020/7

N2 - 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.

AB - 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.

U2 - 10.1007/s00167-020-05922-9

DO - 10.1007/s00167-020-05922-9

M3 - SCORING: Journal article

C2 - 32239270

VL - 28

SP - 2116

EP - 2123

JO - KNEE SURG SPORT TR A

JF - KNEE SURG SPORT TR A

SN - 0942-2056

IS - 7

ER -