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 journalArticlepeer-review

    10 Citations (Scopus)
    78 Downloads (Pure)


    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


    Dive into the research topics of 'Core set of unfavorable events of shoulder arthroplasty: an international Delphi consensus process'. Together they form a unique fingerprint.

    Cite this