4.3 Article

Complications associated with arthroscopic rotator cuff tear repair: definition of a core event set by Delphi consensus process

Journal

JOURNAL OF SHOULDER AND ELBOW SURGERY
Volume 25, Issue 12, Pages 1907-1917

Publisher

MOSBY-ELSEVIER
DOI: 10.1016/j.jse.2016.04.036

Keywords

Shoulder; rotator cuff; complications; standardization; Delphi process; core event set

Funding

  1. Schulthess Clinic

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Background: The literature does not consistently report on complications associated with arthroscopic rotator cuff repair (ARCR). Valid comparison of the occurrence of complications between ARCR interventions requires standardization. This project was implemented to define a core set of negative (untoward) events associated with ARCR along with their terms and definitions, which should be systematically documented and reported in routine care and clinical research. Materials and methods: A Delphi consensus process was applied. An international panel of experienced shoulder surgeons was nominated through professional societies and personal contacts. On the basis of a systematic review of terms and definitions, an organized list of relevant events associated with ARCR was developed and reviewed by panel members. Between each survey, all comments and suggestions were considered to revise the proposed core set, including local event groups along with definitions, specifications, and timing of occurrence. Consensus was defined as at least two-thirds agreement. Results: Three successive online surveys were implemented involving 84 surgeons. Consensus with over 86% agreement was reached for a core list of local events including 3 intraoperative event groups (device, osteochondral, and soft tissue) and 9 postoperative event groups (device, osteochondral, pain, rotator cuff, surgical-site infection, peripheral neurologic, vascular, superficial soft tissue, and deep soft tissue). Experts agreed on a period for documentation of each event or group of events ranging from 3 to 24 months after ARCR. Conclusion: A structured core set of local events associated with ARCR has been developed by international consensus. Further evaluation and validation in the context of clinical studies are required. (C) 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.

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