Management of posterior cruciate ligament injuries: an expert consensus from 17 countries

Abstract

BACKGROUND: Posterior cruciate ligament (PCL) injury is a relatively common musculoskeletal condition. However, there is currently a lack of consensus on decision-making, treatment and postoperative management for such injuries. OBJECTIVES: To use the modified Delphi method to reach expert consensus on the management of PCL injury. METHODS: A literature search of PubMed, Cochrane Library, Embase, and Web of Science for articles up to 17 October 2024, to support the development of recommendation statements. An Expert Panel of 90 experienced clinicians from orthopedics and sports medicine participated in a two-round Delphi process. Each statement was evaluated in two parts: the first part assessed content appropriateness (score of 7-9 indicating appropriateness and 4-6 indicating possible appropriateness), while the second part assessed agreement (score of 5-9 indicating agreement). RESULTS: The panel members developed 11 statements using the Delphi process, addressing the following topics: (1) clinical decision-making, (2) treatment, and (3) postoperative management about PCL injuries. The final consensus was reached on 11 statements and we eventually translated these statements into a corresponding table of expert recommendations. CONCLUSION: Consensus was reached on 11 statements regarding three aspects of PCL injury management. These findings provide a foundation for developing evidence-based guidelines that can enhance clinical decision-making, improve treatment strategies, and optimize postoperative care for patients with PCL injuries.