Abstract：
OBJECTIVE: To implement the Formal Consensus Method among a group of experts in shoulder surgery in Latin America, in order to establish appropriate indications for the surgical treatment of massive and irreparable rotator cuff injuries.
METHODS: The Formal Consensus Method was used to develop surgical treatment recommendations for massive and irreparable rotator cuff tears (MIRCT). Three independent groups of experts in shoulder surgery were confirmed. The steering group conducted a systematic literature review and constructed a voting matrix consisting of 348 clinical scenarios. The rating group, composed of 15 members, rated each scenario on two occasions: first anonymously and then during an in-person discussion meeting. The median and voting ranges were used to classify each scenario as inappropriate, uncertain, or appropriate for each surgical technique. Finally, the reading group, consisting of 10 surgeons, reviewed, evaluated and rated the recommendations derived from the detailed analysis of the voting grids.
RESULTS: The main finding of the study reveals a high percentage (70%) of clinical scenarios in which consensus was achieved regarding the appropriateness or inappropriateness of different surgical alternatives for the treatment of massive and irreparable rotator cuff injuries. Through a detailed analysis of the voting grids, a total of 20 recommendations were elaborated concerning the appropriateness of various surgical techniques in addressing irreparable rotator cuff tears.
CONCLUSIONS: The indications for the operative treatment of MIRCT were determined based on expert consensus and the best available evidence, they seek to provide guidance on the appropriateness of various surgical techniques for different clinical scenarios.
METHODS: V.
METHODS: The Formal Consensus Method was used to develop surgical treatment recommendations for massive and irreparable rotator cuff tears (MIRCT). Three independent groups of experts in shoulder surgery were confirmed. The steering group conducted a systematic literature review and constructed a voting matrix consisting of 348 clinical scenarios. The rating group, composed of 15 members, rated each scenario on two occasions: first anonymously and then during an in-person discussion meeting. The median and voting ranges were used to classify each scenario as inappropriate, uncertain, or appropriate for each surgical technique. Finally, the reading group, consisting of 10 surgeons, reviewed, evaluated and rated the recommendations derived from the detailed analysis of the voting grids.
RESULTS: The main finding of the study reveals a high percentage (70%) of clinical scenarios in which consensus was achieved regarding the appropriateness or inappropriateness of different surgical alternatives for the treatment of massive and irreparable rotator cuff injuries. Through a detailed analysis of the voting grids, a total of 20 recommendations were elaborated concerning the appropriateness of various surgical techniques in addressing irreparable rotator cuff tears.
CONCLUSIONS: The indications for the operative treatment of MIRCT were determined based on expert consensus and the best available evidence, they seek to provide guidance on the appropriateness of various surgical techniques for different clinical scenarios.
METHODS: V.
摘要：
目的：在拉丁美洲的肩关节外科专家组中实施正式共识方法，为了建立适当的适应症，以手术治疗巨大的和不可修复的肩袖损伤。
方法：正式共识方法用于为巨大且不可修复的肩袖撕裂（MIRCT）制定手术治疗建议。接受了三个独立的肩关节手术专家小组。指导小组进行了系统的文献综述，并构建了由348个临床情景组成的投票矩阵。评级组，由15名成员组成，在两种情况下对每个场景进行了评级：首先是匿名的，然后是在面对面的讨论会议上。中位数和投票范围被用来将每个场景分类为不合适的，不确定,或适合每种手术技术。最后,阅读小组,由10名外科医生组成，reviewed,评估，并对投票网格详细分析得出的建议进行了评级。
结果：该研究的主要发现揭示了高比例（70％）的临床情景，在不同手术替代方案治疗巨大且不可修复的肩袖损伤的适当性或不适当性方面达成了共识。通过对投票网格的详细分析，共有20项建议涉及各种外科技术在解决不可修复的肩袖撕裂方面的适当性.
结论：根据专家共识和现有的最佳证据确定MIRCT手术治疗的适应症，他们寻求就不同临床情况下各种手术技术的适当性提供指导。
方法：V.
方法：正式共识方法用于为巨大且不可修复的肩袖撕裂（MIRCT）制定手术治疗建议。接受了三个独立的肩关节手术专家小组。指导小组进行了系统的文献综述，并构建了由348个临床情景组成的投票矩阵。评级组，由15名成员组成，在两种情况下对每个场景进行了评级：首先是匿名的，然后是在面对面的讨论会议上。中位数和投票范围被用来将每个场景分类为不合适的，不确定,或适合每种手术技术。最后,阅读小组,由10名外科医生组成，reviewed,评估，并对投票网格详细分析得出的建议进行了评级。
结果：该研究的主要发现揭示了高比例（70％）的临床情景，在不同手术替代方案治疗巨大且不可修复的肩袖损伤的适当性或不适当性方面达成了共识。通过对投票网格的详细分析，共有20项建议涉及各种外科技术在解决不可修复的肩袖撕裂方面的适当性.
结论：根据专家共识和现有的最佳证据确定MIRCT手术治疗的适应症，他们寻求就不同临床情况下各种手术技术的适当性提供指导。
方法：V.
