Oxford Hip Score (OHS)
Postoperative hip-related quality of life
The Oxford Hip Score (OHS) is a validated questionnaire developed at the University of Oxford specifically to assess patient-reported outcomes after total hip arthroplasty implantation. Pain and physical functioning are the main domains of this instrument, which consists of a total of 12 items.
The instrument is convincing due to its simplicity and intuitive scoring system; however, a lack of question clarity has been criticized in several studies. Nevertheless, the OHS showed good comparability with the more commonly used Harris Hip Score and can be considered a valid questionnaire for outcome assessment after hip surgery.
Indication
Items - Dimensions - Completion time
The questionnaire comprises 12 questions, each with 5 possible answers. Only one answer per question may be selected.
Two domains characterize the OHS: pain (general, getting up from sitting, sudden severe pain in the hip, pain at night in bed, interference with work due to pain) and physical functioning (washing/drying, transporting, putting on socks, household/shopping, climbing stairs, walking time before pain, limping).
There is no information in the literature regarding how long it takes to complete the OHS. We assume a completion time of 5 minutes.
Scoring method
The results of the questionnaire are combined to generate a total score.
Responses to each item are linked to a score from 0 to 4, with 0 representing the best possible health outcome and 4 representing the most hip-related limitations. The first version of the OHS used a score from 1 to 5, which can now be considered an obsolete scoring mechanism. The OHS total score is calculated by summing the scores from all questions. 6
Score interpretation
The higher the score, the worse the outcome.
The score ranges from 0 to 48 (12 to 60 in the old version). 48 represents the worst possible score and indicates the most hip-related health limitations. 0 represents the best possible score, meaning no hip-related problems.
Oxford University Innovation, Oxford, United Kingdom10
A license must be applied for an obtained to use the questionnaire. Fees apply for commercial users (industry, CROs, for-profit companies, private healthcare facilities, and medical device manufacturers) and academic projects funded by commercial entities (e.g., an industry-funded university research project). Use is free for government/charitable projects, unfunded projects (funding only from universities or individual donors), individual physician practices, and publicly funded health care. Additionally, fees for support materials (user manuals, translations) apply. 11
The OHS was developed for pen and paper recording, ePRO, and telephone performance. In addition, it represents a very specific instrument for assessing total hip arthroplasty outcomes, with a simpler scoring system and more simplicity compared to the Harris Hip Score, one of the most common PRO instruments for assessing hip-related pain and function. 12
A lack of clarity in the questions was noted (especially in relation to the use of assistive devices). 13
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References
Dawson, Jill, et al. “Questionnaire on the perceptions of patients about total hip replacement.” The Journal of bone and joint surgery. British volume 78.2 (1996): 185-190.
Young, Simon W., et al. “Periprosthetic femoral fractures after total hip arthroplasty.” ANZ journal of surgery 77.6 (2007): 424-428.
Andrew, J. G., et al. “Obesity in total hip replacement.” The Journal of bone and joint surgery. British volume 90.4 (2008): 424-429.
Costa, Matthew L., et al. “Total hip arthroplasty versus resurfacing arthroplasty in the treatment of patients with arthritis of the hip joint: single centre, parallel group, assessor blinded, randomised controlled trial.” bmj 344 (2012).
Pollard, T. C. B., et al. “Is the Birmingham hip resurfacing worthwhile?.” Hip International 13.1 (2003): 25-28.
https://innovation.ox.ac.uk/wp-content/uploads/2014/09/OHS-Scoring-System_2018-01-23.pdf
Impellizzeri, Franco M., et al. “Validity, reproducibility, and responsiveness of the Oxford hip score in patients undergoing surgery for femoroacetabular impingement.” Arthroscopy: The Journal of Arthroscopic & Related Surgery 31.1 (2015): 42-50.
Uesugi, Yuko, et al. “Validity and responsiveness of the Oxford hip score in a prospective study with Japanese total hip arthroplasty patients.” Journal of Orthopaedic Science 14.1 (2009): 35.
Naal, Florian D., et al. “Reliability and validity of the cross-culturally adapted German Oxford hip score.” Clinical orthopaedics and related research 467.4 (2009): 952-957.
https://innovation.ox.ac.uk/outcome-measures/oxford-hip-score-ohs/
https://process.innovation.ox.ac.uk/clinical/
Kalairajah, Yegappan, et al. “Health outcome measures in the evaluation of total hip arthroplasties—a comparison between the Harris hip score and the Oxford hip score.” The Journal of arthroplasty 20.8 (2005): 1037-1041.
Wylde, Vikki, Ian D. Learmonth, and Victoria J. Cavendish. “The Oxford hip score: the patient’s perspective.” Health and quality of life outcomes 3.1 (2005): 1-8.