Editorial Commentary: Delphi Consensus Clarifies Diagnosis, Treatment, Rehabilitation, and Return to Play but Is...

Delphi methodology has become increasingly prevalent in orthopaedics and sports medicine, reflecting the growing use of consensus-based approaches in areas with limited high-level evidence. Recent guidance emphasizes strict adherence to methodological standards, transparency in authorship, and appropriate acknowledgment of both steering committees and expert panels. A recent Delphi initiative examined diagnostic and therapeutic strategies for rotator cuff tears, engaging an international panel of surgeons. The project produced comprehensive recommendations, capturing the collective experience and insights of experts from multiple countries and continents. However, methodological deviations, such as early-round input from subgroups rather than the full panel and the use of survey items combining multiple clinical variables, introduce potential bias and confounding. These factors may limit the interpretability, validity, and nuanced value of the reported consensus. Despite these limitations, the expert insights offer a valuable resource for clinical decision-making. The recommendations should be considered thoughtfully, weighing the collective experience of the panel against potential methodological constraints.