Evidence map›Paper›PMID 39010716›Full record

ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2025

Visible fluid motion on manipulation as the new threshold for intraoperatively determined knee arthroplasty component loosening: A Delphi study.

George S Buijs, Arthur J Kievit, Alex B Walinga, Matthias U Schafroth, Michael T Hirschmann, Leendert Blankevoort, International Consensus Panel

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Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

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0cells of the map it votes in
4citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

George S BuijsDepartment of Orthopedic Surgery and Sport Medicine, Amsterdam UMC, Location AMC, Amsterdam, The Netherlands.ORCID http://orcid.org/0000-0003-3550-3380
Arthur J KievitDepartment of Orthopedic Surgery and Sport Medicine, Amsterdam UMC, Location AMC, Amsterdam, The Netherlands.
Alex B WalingaDepartment of Orthopedic Surgery and Sport Medicine, Amsterdam UMC, Location AMC, Amsterdam, The Netherlands.
Matthias U SchafrothDepartment of Orthopedic Surgery and Sport Medicine, Amsterdam UMC, Location AMC, Amsterdam, The Netherlands.
Michael T HirschmannDepartment of Orthopedic Surgery and Traumatology, Kantonsspital Baselland, Bruderholz, Switzerland.
Leendert BlankevoortDepartment of Orthopedic Surgery and Sport Medicine, Amsterdam UMC, Location AMC, Amsterdam, The Netherlands.
International Consensus Panel

Funding

An Internal TKI-PPP grant from the Amsterdam University Medical Center
6 · The paper itself

Abstract

purposeThere is a lack of a clear, uniform definition for intraoperatively assessed component loosening of a knee arthroplasty component, complicating the interpretation and interchangeability of results of diagnostic studies using an intraoperative observation as the reference test. The purpose of this study was to establish a consensus among specialised knee revision surgeons regarding the definition of intraoperatively determined loosening of total or unicondylar knee arthroplasty components.

methodsUtilising the Delphi consensus method, an international panel of highly specialised knee revision surgeons was invited to participate in a three-round process. The initiation of the first round involved the exploration of possible criteria for intraoperatively determined loosening with open questions. The second round focused on rating these criteria importance on a five-point Likert scale. For the third round, criteria that reached consensus were summarised in consecutive definitions for intraoperatively determined loosening and proposed to the panel. Consensus was established when over 70% of participants agreed with a definition for intraoperatively determined loosening.

resultsThe 34 responding panel members described in total 60 different criteria in the first round of which 34 criteria received consensus in the second round. Summarising these criteria resulted in four different definitions as minimal requirements for intraoperatively determined loosening. Eighty-eight percent of the panel members agreed on defining a component as loose if there is visible fluid motion at the interface observed during specific movements or when gently applying direct force.

conclusionThis study successfully established a consensus using a Delphi method among knee revision surgeons on the definition of intraoperatively determined component loosening. By agreeing on the visibility of fluid motion as new definition, this study provides a standardised reference for future diagnostic research. This definition will enhance the interpretability and interchangeability of future diagnostic studies evaluating knee arthroplasty component loosening. LEVEL OF EVIDENCE: Level V.

Indexed as

Arthroplasty, Replacement, KneeDelphi TechniqueKnee ProsthesisProsthesis FailureConsensusHumansReoperationaseptic looseningconsensusdiagnostic accuracyintraoperative findingsknee arthroplastyreference testrevision knee arthroplasty

Identifiers

PMID39010716
PMCPMC11716369

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