Most Publications Regarding Arthroscopic Treatment of Posterolateral Corner Injuries of the Knee Have a Low Level of Evidence and Provide Limited Information to Determine the Most Effective Treatment

Abstract

Purpose: To examine the Level of Evidence and overall quality of studies addressing arthroscopic posterolateral corner reconstructions of the knee. Methods: A search was performed using the PubMed/Medline, Web of Science, and Google Scholar databases for all studies investigating arthroscopic treatment of posterolateral corner injuries of the knee. Studies reporting outcomes or describing arthroscopic techniques for treatment of posterolateral corner injuries of the knee were the focus of this analysis. Clinical as well as biomechanical and cadaveric studies were included. Studies only investigating open techniques were excluded. Two independent reviewers determined the level of evidence for each included study using the criteria established by the Journal of Bone and Joint Surgery and scored each clinical study from 0 to 100 based on 10 criteria from the modified Coleman Methodology Score. Results: Twenty-four studies matched the inclusion criteria. There were 6 cadaveric technique descriptions, 6 clinical technique descriptions, 3 biomechanical studies, 4 technical repair descriptions, and 5 clinical outcome studies. Thirty-eight percent of all studies were of Level V evidence. Fifty percent of studies were of Level IV evidence, and 12% of studies were of Level III evidence. The mean modified Coleman Methodology Score for the clinical studies was 43 ± 11.4, which is regarded as poor, mainly due to the limited number of patients and the retrospective nature of the studies. Conclusions: Most studies addressing arthroscopic posterolateral corner reconstruction of the knee are of low level of evidence and provide limited information about the best treatment options. Clinical Relevance: The number of publications on arthroscopic posterolateral corner reconstruction techniques continues to rise. This systematic review evaluates the level of evidence of these studies.