Consensus on long-term follow-up and surveillance of elective primary shoulder arthroplasty using a real-time Delphi technique.

Abstract

BACKGROUND: Long-term follow-up of elective primary shoulder arthroplasty remains contentious. A real-time Delphi technique allows a single survey to obtain a consensus from experts on the optimum surveillance protocol. METHODS: A real-time Delphi consensus study was delivered using Surveylet. Delphi statements surveyed whether a type of shoulder arthroplasty requires follow-up in the initial 10 postoperative years and beyond 10 postoperative years. Further statements related to surveillance episode format were included. British Elbow and Shoulder Society members were invited to participate. Participants rated agreement with statements using a 5-point Likert scale. Study results were used to produce expert-opinion recommendations that were presented to a patient group. RESULTS: The study received 37 responses of which 31 were complete. 78% of respondents were orthopaedic surgeons and 19% were physiotherapists. Mean survey visits per participant was 3.8 (total 140). The patient group included 13 patients. Consensus agreement was reached on surveillance requirement for numerous shoulder arthroplasty types and aspects of surveillance format, including requirement for radiological assessment and completion of a patient-reported outcome measure. All patients expressed agreement with the resulting expert-opinion recommendations. DISCUSSION: A real-time Delphi among expert clinicians identified areas of consensus in long-term surveillance of elective primary shoulder arthroplasty.