AQUILA: assessment of quality in lower limb arthroplasty. An expert Delphi consensus for total knee and total hip arthroplasty

Abstract

BackgroundIn the light of both the importance and large numbers of case series and cohort studies (observational studies) in orthopaedic literature, it is remarkable that there is currently no validated measurement tool to appraise their quality. A Delphi approach was used to develop a checklist for reporting quality, methodological quality and generalizability of case series and cohorts in total hip and total knee arthroplasty with a focus on aseptic loosening.MethodsA web-based Delphi was conducted consisting of two internal rounds and three external rounds in order to achieve expert consensus on items considered relevant for reporting quality, methodological quality and generalizability.ResultsThe internal rounds were used to construct a master list. The first external round was completed by 44 experts, 35 of them completed the second external round and 33 of them completed the third external round. Consensus was reached on an 8-item reporting quality checklist, a 6-item methodological checklist and a 22-item generalizability checklist.ConclusionsChecklist for reporting quality, methodological quality and generalizability for case series and cohorts in total hip and total knee arthroplasty were successfully created through this Delphi. These checklists should improve the accuracy, completeness and quality of case series and cohorts regarding total hip and total knee arthroplasty.

Success After Treatment of Periprosthetic Joint Infection: A Delphi-based International Multidisciplinary Consensus

“…Even though a relatively low response rate may introduce an inherent unmeasurable bias, other studies that have used the Delphi method obtaining valid results have had similar response rates [34,36]. Additionally, the response rate in our study exceeded the response rate observed in other studies [33,39]. The use of a modified Delphi method (with one round having participants interacting directly) [4] may have reached a higher rate of response.…”

Differences in long-term fixation between mobile-bearing and fixed-bearing knee prostheses at ten to 12 years’ follow-up

“…The groups were similar with regard to age, gender, diagnosis, body mass index (BMI), pre-operative limb alignment and function (Table I). 16 Patients were followed prospectively at three and six weeks, three and six months, and then annually for ten to 12 years post-operatively. During the course of the study eight patients (11 TKRs: three MB, eight FB) died of causes unrelated to surgery.…”

Minimal clinically important differences in health-related quality of life after total hip or knee replacement

“…(no loss to follow-up/< 5% lost to follow-up (unlikely to bias results)/> 5% lost to follow-up (results possibly biased)). We chose the cut-off point of 5% lost to follow-up according to Pijls et al, 15 who established this threshold for observational studies in orthopaedic literature, using a Delphi approach to form consensus between a group of experts in the fields of THR, TKR or evidence-based medicine.…”