Harris Hip Score (HHS)
Evaluation of hip disability and hip surgery results
The Harris Hip Score (HHS) is a joint-specific validated tool for evaluation of hip disability and assessment of hip surgery results.
It consists of 8 items to be answered by the patient regarding pain and functional capacity and 2 items that are to be answered by the examining clinician regarding range of motion and absence of deformity.
By requiring clinician input, the HHS differs from many other patient-reported outcome measures. The HHS is typically used for patients undergoing total hip replacement as well as patients with femoral neck fractures and hip osteoarthritis.
Items - Dimensions - Completion time
The patient has to select 1 of 2–6 response options per item for 8 items. The examining clinician has to measure several clinical parameters for 2 items.
Hip-related health is evaluated by the dimensions of pain and functional capacity (broken down into daily activities— stairs, public transport, sitting, and shoes and socks—and gait, considered in terms of limp, support and distance walked), as well as two clinical parameters (range of motion and absence of deformity).
Nilsdotter and Bremander report that it takes 5 minutes to complete 6.
Each item has a specific numerical scale that corresponds to descriptive response options. The number of points linked to each response option varies.
The range of motion item considers 6 motions, which are graded based on the arc of motion possible. Each range of motion gradation is linked to an index factor and a maximum possible value, which are used to calculate arc of motion points.
These points are added and multiplied by 0.05 to determine the total point for range of motion. The total score for the HHS is calculated by adding up the scores for the 4 domains (pain, functional capacity, range of motion and absence of deformity), yielding a single score.
The score for the HHS ranges from a maximum of 100 to a minimum of 0. 6
The higher the score, the less the dysfunction:
< 70: poor
90–100: excellent 7
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Nilsdotter, Anna, and Ann Bremander. “Measures of hip function and symptoms: Harris hip score (HHS), hip disability and osteoarthritis outcome score (HOOS), Oxford hip score (OHS), Lequesne index of severity for osteoarthritis of the hip (LISOH), and American Academy of orthopedic surgeons (AAOS) hip and knee questionnaire.” Arthritis care & research 63.S11 (2011): S200-S207.