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Purpose To develop a statement on the diagnosis, classification, treatment, and rehabilitation concepts of posterolateral corner (PLC) injuries of the knee using a modified Delphi technique. Methods A working group of three individuals generated a list of statements relating to the diagnosis, classification, treatment, and rehabilitation of PLC injuries to form the basis of an initial survey for rating by an international group of experts. The PLC expert group (composed of 27 experts throughout the world) was surveyed on three occasions to establish consensus on the inclusion/exclusion of each item. In addition to rating agreement, experts were invited to propose further items for inclusion or to suggest modifications of existing items at each round. Pre‐defined criteria were used to refine item lists after each survey. Statements reaching consensus in round three were included within the final consensus document. Results Twenty‐seven experts (100% response rate) completed three rounds of surveys. After three rounds, 29 items achieved consensus with over 75% agreement and less than 5% disagreement. Consensus was reached in 92% of the statements relating to diagnosis of PLC injuries, 100% relating to classification, 70% relating to treatment and in 88% of items relating to rehabilitation statements, with an overall consensus of 81%. Conclusions This study has established a consensus statement relating to the diagnosis, classification, treatment, and rehabilitation of PLC injuries. Further research is needed to develop updated classification systems, and better understand the role of non‐invasive and minimally invasive approaches along with standardized rehabilitation protocols. Level of evidence Consensus of expert opinion, Level V.

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The goal of this paper was to document the injury rate in modern competitive karate. A prospective recording of the injuries resulting from 2,837 matches in three consecutive World Karate Championships (WKC) was performed. Eight hundred and ninety-one injuries were recorded, with an incidence of 0.31 injuries per match or 157.03 injuries per 1,000 athlete exposures. Occurrence of injuries was higher among lighter categories, under 60 kg in males (0.56) and under 53 kg in females (0.42). Punches (737, 82.7%) caused more injuries than kicks (75, 7.3%). The injuries were most commonly located in the face (646, 72.5%) followed by the head (103, 11.6%) and lower limbs (57, 6.4%). The injuries consisted primarily of contusions (448, 50.3%) epistaxis (144, 16.2%) and lacerations (122, 13.7%) followed by concussions (34, 3.8%) and sprains (31, 3.5%). There was some kind of external haemorrhage in 296 injuries (33.7%). The injury rate was similar in the three WKC but the number of severe injuries declined from 1996 to 2000. We conclude that competitive karate is associated with a relatively high injury rate; in one in every three matches medical attention is required, but mainly for minor injuries. Severe injuries are rare.

The aim of this paper is to document the injury rate in high-level modern competitive karate after a change of competition rules was implemented in the year 2000, and to compare it with the injury rate found before the rules were changed. A prospective recording of the injuries resulting from 2,762 matches in three consecutive World Karate Championships (representing 7,425 min of active fighting) was performed, and compared with the results from 2,837 matches from the three last World Karate Championships (representing 7,631 min of active fighting) held before the change of competition rules. In total, 497 injuries were recorded, with an incidence of 0.180 injuries per match or 6.7 per 100 min of active fighting. There were 1,901 male category fights (in which 383 injuries were recorded), and 861 female category fights (in which 114 injuries were recorded). The global injury incidence was almost double with the old rules compared to the one with the new rules [OR 1.99, 95% CI (1.76-2.26); p < 0.00001]. In male category, the risk of injury was higher before the rules were changed [OR 1.81, 95% CI (1.56-2.09); p < 0.00001], and also in female category [OR 2.71; 95% CI (2.64-2.80); p < 0.00001]. The rate of severe injuries was not different before and after the change of rules. The implementation of the new competition rules in competitive karate has been associated with a significant reduction in injury rate, making competition safer for athletes.