A consensus-based classification of minor complications, major complications, and failure after anterior cruciate ligament reconstruction: A modified delphi study.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
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D'Ambrosi Riccardo, Ackermann Jakob, Deichsel Adrian, Eckl Larissa, Eggeling Lena, Kittl Christoph, Laky Brenda, Mathis Dominic, Merkely Gergo B, Muench Lukas Nawid, Muenchgesang Maiti, Schmidt Anton Ferdinand, Schuettler Karl-Friederich, Wafaisade Arasch, Abermann Elisabeth, Achtnich Andrea, Akoto Ralph, Angele Peter, Becker Roland, Brandl Georg, Dejour David, Dirisamer Florian, Drews Björn H, Egloff Christian, Feucht Matthias J, Fink Christian, Herbst Elmar, Hohmann Erik, Imhoff Andreas B, Jung Tobias, Koch Peter Philipp, Krause Matthias, Lattermann Christian, Lubowitz James H, Mehl Julian, Mengis Natalie, Mushal Volker, Nehrer Stefan, Pfeiffer Thomas, Scheffler Sven, Schoepp Christian, Siebold Rainer, Volz Martin, Williams Andy, Willinger Lukas, Zantop Thore, Zellner Johannes, Guenther Daniel, Society for Arthroscopy and Joint Surgery (AGA) Research Committee
Аннотация
METHODS: A three-round modified Delphi process was conducted involving international high-volume ACL surgeons. An initial set of statements addressing potential postoperative events after ACLR was developed by a working group based on clinical expertise and contemporary literature. Panelists classified each statement as no complication/normal clinical course, minor complication, major complication, or failure. Consensus was predefined as ≥75% agreement within a single category. Statements reaching consensus were retained, whereas non-consensus statements were revised and re-evaluated in subsequent rounds.
RESULTS: Thirty-nine experts completed the first and second Delphi rounds, and 30 (76.9%) completed the third round. The initial 52 statements were expanded to 67 in round two and refined to 46 in round three. Consensus was achieved for 14 statements (26.9%) in round one, 21 statements (31.3%) in round two, and 20 statements (43.5%) in round three. Overall, consensus was reached for 55 statements, forming the final classification framework. The panel clearly distinguished graft failure-defined as graft insufficiency or symptomatic instability-from major complications requiring surgical intervention or associated with substantial morbidity, and from minor complications or expected postoperative findings. Notably, traumatic graft rupture following a clearly documented new injury was not considered a postoperative complication.
CONCLUSIONS: This international Delphi consensus establishes a standardized and clinically meaningful classification of postoperative events following ACLR. By clearly distinguishing no complication, minor complication, major complication, and failure, this framework provides a shared language that may improve consistency in outcome reporting, facilitate comparison across studies, and enhance the interpretability of clinical research and registry data.
LEVEL OF EVIDENCE: V, expert consensus.