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.

Aarhus University Hospital Aarhus Denmark

Ars Ortopedica Clinical Ars Medica Gravesano Switzerland

Asklepios Clinic St Georg Hamburg Germany

Asklepios Klinik St Georg Chirurgisch Traumatologisches Zentrum Hamburg Germany

Avon Orthopaedic Centre Bristol UK

Cape Town Sports and Orthopaedic Clinic Cape Town South Africa

Centre Hospitalier de Versailles Le Chesnay France

Centro de Tratamiento de Enfermedades Articulares Buenos Aires Argentina

Clínica CEMTRO Madrid Spain

Clinique du Sport de Bordeaux Mérignac Bordeaux France

Department of Orthopaedic Surgery Hospital de La Sta Creu 1 Sant Pau Universitat Autònoma de Barcelona Barcelona Spain

Department of Orthopaedic Surgery Hospital for Special Surgery New York NY USA

Department of Orthopaedics Sahlgrenska University Hospital Sahlgrenska Academy Gothenburg University Gothenburg Sweden

Division of Sports Medicine Department of Orthopaedic Surgery Rush University Medical Center 1611 W Harrison Street Suite 300 Chicago IL 60612 USA

Fowler Kennedy Sports Medicine Clinic London ON Canada

Hospital Clinico Mutual de Seguridad Santiago Chile

Hospital La Fraternidad Habana Madrid Spain

ICATME Hospital Universitari Dexeus Universitat Autònoma de Barcelona Barcelona Spain

International Knee and Joint Centre Abu Dhabi UAE

Istituto Ortopedico Rizzoli University of Bologna Bologna Italy

Melbourne Orthopaedic Group Melbourne Australia

Nanometer Structure Consortium Lund University Lund Sweden

Oslo Sports Trauma Research Center Oslo Norway

Oslo University Hospital Oslo Norway

Parc de Salut Mar UAB Barcelona Spain

Sports Traumatology Center Sports Medicine and Rehabilitation Clinic Tartu University Hospital Tartu Estonia

Stockholm South Hospital Karolinska Institutet Stockholm Sweden

Sydney Orthopaedic Research Institute Sydney Australia

Twin Cities Orthopaedics Edison MN USA

Universidade Federal de São Paulo São Paulo SP Brazil

University Hospital Motol Prague Czech Republic

University Hospital of Geneva Geneva Switzerland

University Medical Center Hamburg Eppendorf Hamburg Germany

University of Pavia IRCCS Policlinico San Matteo Pavia Italy

University of Rome Foro Italico Rome Italy

University of Thessalia Larissa Greece

Wakamatsu Hospital University of Occupational and Environmental Health Kitakyushu Japan

Zentrum Für Spezielle Gelenkchirurgie Berlin Germany

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