Developing a Core Outcome Set for Prognosis of Hip Osteonecrosis in Iranian Population: A Multimethod Study Publisher



Faezi ST ; Ahmadi SAY ; Mokhtarbaf N ; Elmi M ; Tehranibanihashemi A
Source: Advances in Orthopedics Published:2026

Abstract

Introduction: Core outcome set (COS) is a consensus-based set of outcomes derived from a multimethod technique. The present study aimed to develop a COS for prognosis of hip osteonecrosis in response to treatment which was suitable for Iranian patients, and we performed stakeholder analysis. Methods: This multimethod study was conducted in the following phases: (1) extraction of outcomes through an umbrella review of the previous meta-analyses, (2) expert panel survey, (3) qualitative interview with patients, and (4) compilation of the COS with the help of triangulation of study phases. Results: The umbrella review was performed on 34 documents. The outcomes were generally classified into several categories including clinical, radiological, and surgical outcomes. In the second phase, the expert panel proposed the outcomes as time to return to work, time to return to daily activity, joint range of motion, improvement in walking, bone swelling, weight bearing, extent of necrosis, conversion to total hip arthroplasty (THA), pain reduction, improvement in hygiene, and improvement in function. In the third phase, patients mainly complained of joint stiffness, and this was the first outcome that reached saturation in the interview. Finally, the COS was presented. Conclusion: The main focus was on the clinical outcomes, which were prioritized in the triangulation of the methods and the opinion of the stakeholders. Patients are looking for their movement problems and limitations to be corrected as soon as possible and to return to their daily activities. The final COS of this study for clinical use includes pain, joint range of motion and lack of stiffness, improvement in function, ability to walk, and return to daily activity. Copyright © 2026 Seyedeh Tahereh Faezi et al. Advances in Orthopedics published by John Wiley & Sons Ltd.