Jacxsens Matthijs, Walz Theodor, Durchholz Holger, Müller Andreas M, Flury Matthias, Schwyzer Hans-Kaspar, Audigé Laurent
Department of Orthopaedic Surgery and Traumatology, University Hospital of Basel, Basel, Switzerland.
Research and Development, Schulthess Clinic, Zurich, Switzerland.
Arch Orthop Trauma Surg. 2017 Mar;137(3):347-355. doi: 10.1007/s00402-017-2635-9. Epub 2017 Feb 6.
A transparent, reliable and accurate reporting of complications is essential for an evidence-based evaluation of shoulder arthroplasty (SA). We systematically reviewed the literature for terms and definitions related to negative events associated with SA.
Various biomedical databases were searched for reviews, clinical studies and case reports of complications associated with SA. Any general definition of a complication, classification system, all reported terms related to complications and negative events with their definitions were extracted. Terms were grouped and organised in a hierarchical structure. Definitions of negative events were tabulated and compared.
From 1086 initial references published between 2010 and 2014, 495 full-text papers were reviewed. Five reports provided a general definition of the term "surgical complication" and 29 used a classification system of complications. A total of 1399 extracted terms were grouped based on similarities and involved implant or anatomical parts. One hundred and six reports (21.4%) defined at least one negative event for 28 different terms. There were 64 definitions related to humeral or glenoid loosening, and 25 systems documenting periprosthetic radiolucency. Other definitions considered notching, stress shielding, implant failure and tuberosity malposition.
A clear standardised set of SA complication definitions is lacking. Few authors reported complications based on definitions mainly considering radiological criteria without clinical parameters. This review should initiate and support the development of a standardised SA complication core set.
对于基于证据的肩关节置换术（SA）评估而言，透明、可靠且准确地报告并发症至关重要。我们系统地回顾了文献中与SA相关的不良事件的术语和定义。
在各种生物医学数据库中搜索与SA相关并发症的综述、临床研究和病例报告。提取并发症的任何通用定义、分类系统、所有报告的与并发症及不良事件相关的术语及其定义。术语被分组并组织成层次结构。将不良事件的定义制成表格并进行比较。
在2010年至2014年发表的1086篇初始参考文献中，对495篇全文论文进行了综述。五篇报告提供了“手术并发症”一词的通用定义，29篇使用了并发症分类系统。根据相似性对总共1399个提取的术语进行了分组，这些术语涉及植入物或解剖部位。106篇报告（21.4%）为28个不同术语定义了至少一种不良事件。有64个与肱骨或肩胛盂松动相关的定义，以及25个记录假体周围透亮线的系统。其他定义考虑了切迹、应力遮挡、植入物失败和结节位置异常。
缺乏一套明确的标准化SA并发症定义。很少有作者根据主要考虑放射学标准而无临床参数的定义来报告并发症。本综述应启动并支持标准化SA并发症核心集的制定。
