Multiligament knee injury (MLKI): an expert consensus statement on nomenclature, diagnosis, treatment and rehabilitation

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dc.contributor.authorMurray, Iain Robert
dc.contributor.authorMakaram, Navnit S.
dc.contributor.authorGeeslin, Andrew G.
dc.contributor.authorChahla, Jorge
dc.contributor.authorMoatshe, Gilbert
dc.contributor.authorCrossley, Kay
dc.contributor.authorKew, Michelle E.
dc.contributor.authorDavis, Aileen
dc.contributor.authorTuca, Maria
dc.contributor.authorPotter, Hollis
dc.contributor.authorvan Rensburg, Dina C. Janse
dc.contributor.authorEmery, Carolyn A.
dc.contributor.authorEun, Seungpyo
dc.contributor.authorGrindem, Hege
dc.contributor.authorNoyes, Frank R.
dc.contributor.authorMarx, Robert G.
dc.contributor.authorHarner, Chris
dc.contributor.authorLevy, Bruce A.
dc.contributor.authorKing, Enda
dc.contributor.authorCook, James L.
dc.contributor.authorWhelan, Daniel B.
dc.contributor.authorWahl, Christopher J.
dc.contributor.authorThorborg, Kristian
dc.contributor.authorIrrgang, James J.
dc.contributor.authorPujol, Nicolas
dc.contributor.authorMedvecky, Michael J.
dc.contributor.authorStuart, Michael J.
dc.contributor.authorHatch III, George F.
dc.contributor.authorKrych, Aaron J.
dc.contributor.authorEngebretsen, Lars
dc.contributor.authorStannard, James P.
dc.contributor.authorMacDonald, Peter
dc.contributor.authorSeil, Romain
dc.contributor.authorFanelli, Gregory C.
dc.contributor.authorMaak, Travis G.
dc.contributor.authorShelbourne, K. Donald
dc.contributor.authorVerhagen, Evert
dc.contributor.authorMusahl, Volker
dc.contributor.authorHirschmann, Michael T.
dc.contributor.authorMiller, Mark D.
dc.contributor.authorSchenck, Robert C.
dc.contributor.authorLaPrade, Robert F.
dc.date.accessioned2025-01-20T16:08:49Z
dc.date.available2025-01-20T16:08:49Z
dc.date.issued2024
dc.description.abstractMultiligament knee injuries (MLKIs) represent a broad spectrum of pathology with potentially devastating consequences. Currently, disagreement in the terminology, diagnosis and treatment of these injuries limits clinical care and research. This study aimed to develop consensus on the nomenclature, diagnosis, treatment and rehabilitation strategies for patients with MLKI, while identifying important research priorities for further study. An international consensus process was conducted using validated Delphi methodology in line with British Journal of Sports Medicine guidelines. A multidisciplinary panel of 39 members from 14 countries, completed 3 rounds of online surveys exploring aspects of nomenclature, diagnosis, treatment, rehabilitation and future research priorities. Levels of agreement (LoA) with each statement were rated anonymously on a 5-point Likert scale, with experts encouraged to suggest modifications or additional statements. LoA for consensus in the final round were defined 'a priori' if >75% of respondents agreed and fewer than 10% disagreed, and dissenting viewpoints were recorded and discussed. After three Delphi rounds, 50 items (92.6%) reached consensus. Key statements that reached consensus within nomenclature included a clear definition for MLKI (LoA 97.4%) and the need for an updated MLKI classification system that classifies injury mechanism, extent of non-ligamentous structures injured and the presence or absence of dislocation. Within diagnosis, consensus was reached that there should be a low threshold for assessment with CT angiography for MLKI within a high-energy context and for certain injury patterns including bicruciate and PLC injuries (LoA 89.7%). The value of stress radiography or intraoperative fluoroscopy also reached consensus (LoA 89.7%). Within treatment, it was generally agreed that existing literature generally favours operative management of MLKI, particularly for young patients (LoA 100%), and that single-stage surgery should be performed whenever possible (LoA 92.3%). This consensus statement will facilitate clinical communication in MLKI, the care of these patients and future research within MLKI.
dc.fuente.origenWOS
dc.identifier.doi10.1136/bjsports-2024-108089
dc.identifier.eissn1473-0480
dc.identifier.issn0306-3674
dc.identifier.urihttps://doi.org/10.1136/bjsports-2024-108089
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/90109
dc.identifier.wosidWOS:001309600600001
dc.language.isoen
dc.revistaBritish journal of sports medicine
dc.rightsacceso restringido
dc.subjectknee
dc.subjectsports
dc.subjectligaments
dc.subjectconsensus
dc.subjectdiagnosis
dc.titleMultiligament knee injury (MLKI): an expert consensus statement on nomenclature, diagnosis, treatment and rehabilitation
dc.typeartículo
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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