Core set of unfavorable events of shoulder arthroplasty

an international Delphi consensus process

Laurent Audigé*, Hans Kaspar Schwyzer, Shoulder Arthroplasty Core Event Set (SA CES) Consensus Panel

*Corresponding author for this work

Research output: Contribution to journalArticle

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Background: Shoulder arthroplasty (SA) complications require standardization of definitions and are not limited to events leading to revision operations. We aimed to define an international consensus core set of clinically relevant unfavorable events of SA to be documented in clinical routine practice and studies. Methods: A Delphi exercise was implemented with an international panel of experienced shoulder surgeons selected by nomination through professional societies. On the basis of a systematic review of terms and definitions and previous experience in establishing an arthroscopic rotator cuff repair core set, an organized list of SA events was developed and reviewed by panel members. After 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 reached with at least two-thirds agreement. Results: Two online surveys were required to reach consensus within a panel involving 96 surgeons. Between 88% and 100% agreement was achieved separately for local event groups including 3 intraoperative (device, osteochondral, and soft tissue) and 9 postoperative event groups. Experts agreed on a documentation period that ranged from 3 to 24 months after SA for 4 event groups (peripheral neurologic, vascular, surgical-site infection, and superficial soft tissue) and that was lifelong until implant revision for other groups (device, osteochondral, shoulder instability, pain, late hematogenous infection, and deep soft tissue). Conclusion: A structured core set of local unfavorable events of SA was developed by international consensus to support the standardization of SA safety reporting. Clinical application and scientific evaluation are needed.

Original languageEnglish
Pages (from-to)2061-2071
Number of pages11
JournalJournal of Shoulder and Elbow Surgery
Issue number11
Publication statusPublished - 1 Nov 2019


Bibliographical note

Copyright the Author(s) 2019. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.


  • arthroplasty
  • complications
  • standardization
  • core event set
  • Delphi process
  • shoulder
  • unfavorable events

Cite this

Audigé, L., Schwyzer, H. K., & Shoulder Arthroplasty Core Event Set (SA CES) Consensus Panel (2019). Core set of unfavorable events of shoulder arthroplasty: an international Delphi consensus process. Journal of Shoulder and Elbow Surgery, 28(11), 2061-2071.