Developing a core outcome set for acetabular fractures: a systematic review (part I)

Background
There are indications that clinical studies investigating the surgical treatment of acetabular fractures assess different outcomes. This heterogeneity reduces the comparability of study results and, thus, limits the knowledge generated from research. Core outcome sets (COS) contain a minimum set of outcomes that should be measured in studies investigating a specific disease or injury. A COS for surgically treated acetabular fractures does not yet exist. Therefore, the aim of this study is to identify the reported outcomes in studies investigating the surgical treatment of acetabular fractures.

Methods
Studies including skeletally mature individuals (=?16 years) with isolated acetabular fractures treated surgically were included. Studies with polytrauma patients, pathological fractures, additional pelvic fractures, exclusively non-surgical treatment, or juvenile individuals were excluded. Three databases and two clinical trial registries were searched on 15 November 2022. The identified outcomes were grouped and subsequently categorized according to the Core Outcome Measures in Effectiveness Trials Guidelines.

Results
A total of 193 studies were included, which reported a cumulative total of 2581 outcomes. After grouping, 266 unique outcomes were identified. No outcome was examined in all studies. Pain, ability to walk independently, range of motion, quality of reduction, and heterotopic ossification were the most reported unique outcomes and assessed in at least 60% of included studies. A total of 105 outcomes were only assessed in one of the included studies. Outcomes of all five core areas and 25 outcome domains of the Core Outcome Measures in Effectiveness Trials taxonomy were examined. Furthermore, outcomes were named and defined differently, measured at different time points, and assessed using a variety of measurement instruments.

Conclusion
Overall, this systematic review shows that a wide range of outcomes are measured in studies examining surgical treatment of acetabular fractures. The results of this systematic review will be used in a subsequent study to develop the COS for surgically treated acetabular fractures by using the Delphi method.

Contributors

Denise Schulz, Catharina Gaeth, Martin C. Jordan, Steven C. Herath, Christopher Spering, Dan Bieler, Joachim Windolf & Anne Neubert

Publication

Journal: Systematic Reviews
Volume: 14
Issue:
Pages: -
Year: 2025
DOI: https://doi.org/10.1186/s13643-025-02824-0

Further Study Information

Current Stage: Completed
Date: November 2022 - January 2024
Funding source(s): Open Access funding enabled and organized by Projekt DEAL. This review is part of the project TraumaEvidence by the German Society of Traumatology and the University Hospital Duesseldorf, Germany. The authors received no specific funding for this work. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.


Health Area

Disease Category: Orthopaedics & trauma

Disease Name: Acetabulum fracture

Target Population

Age Range: 16 - 120

Sex: Either

Nature of Intervention: Surgery

Stakeholders Involved

- Clinical experts
- Researchers

Study Type

- Systematic review of outcomes measured in trials

Method(s)

- Systematic review