|Beitragstitel||Shoulder arthroplasty complications: definition of a core event set by Delphi consensus process|
Introduction: Valid reporting of the occurrence of shoulder arthroplasty (SA) complications requires standardization. We aim to define a consensus core set of negative events (CES) of SA.
Materials and Methods: We initiated a Delphi consensus process with on-line surveys. An international panel of 185 experienced shoulder surgeons was nominated through professional Societies. Based on a systematic review and a recently developed CES in arthroscopic rotator cuff repair, an initial survey was implemented with two parts: one concerning imaging parameters for SA monitoring and the other covering intra- and postoperative adverse events. Open questions captured the experts’ opinion. For closed questions about event groups, definitions, specifications and timing of occurrence, consensus was reached with two-third agreement.
Results: Eighty-nine surgeons (48%) responded. Consensus was reached to further consider and define 8 radiological parameters (radiolucency, loosening, implant migration, signs of instability, bone resorption, stress shielding, scapular notching and implant wear). Consensus with 91-93% agreement was reached for a core list of local events including 3 intra-operative event groups (device, osteochondral, soft tissue) and 8 post-operative event groups (device, osteochondral, pain, surgical site infection, peripheral neurological, vascular, superficial soft tissue, deep soft tissue), along with definitions and specifications. Suggestions for modifications were made. The timing for monitoring postoperative events remained uncertain.
Discussion/Conclusion: A structured core set of local radiological parameters and adverse events of SA is being developed by international consensus. Further Delphi surveys and meetings are required to reach a final agreement as a major step towards the standardization of SA complications.