Hip Outcome Measurements: HOOS Hip disability and Osteoarthritis Outcome Score

The Hip disability and Osteoarthritis Outcome Score (HOOS) is a patient-reported outcome measure designed to assess the impact of hip disability and osteoarthritis on the patient's quality of life. It was developed by Ewa Roos and colleagues in 1998 and has since been widely used in clinical practice and research.

The HOOS questionnaire consists of 40 items across five domains, including pain, symptoms, activities of daily living, sports and recreational activities, and quality of life. Each item is rated on a 5-point Likert scale, with higher scores indicating better hip function and quality of life. The total score ranges from 0 to 100, with higher scores indicating better hip function and quality of life.

The HOOS is used to evaluate patients with hip osteoarthritis who have undergone surgical or non-surgical treatment. It is often used as part of a comprehensive assessment that includes a physical examination, imaging studies, and other outcome measures. The HOOS can be used at different points in the patient's treatment, including before and after surgery or conservative management. It is also used to track the patient's progress over time and to evaluate the effectiveness of interventions.

The HOOS questionnaire consists of five domains, each with a score ranging from 0 to 100. The domains are as follows:

1. Pain
2. Symptoms
3. Activities of daily living
4. Sports and recreational activities
5. Quality of life

The overall score is the sum of all five domain scores, ranging from 0 to 500. Higher scores indicate better hip function and quality of life.

Interpretation of the HOOS scores is dependent on several factors, including the patient's age, comorbidities, and expectations. However, in general, a higher score indicates better hip function and quality of life. A score of 100 represents the best possible outcome, indicating no hip symptoms or limitations.

A score of 0 indicates severe hip dysfunction and the patient's inability to perform activities of daily living. In general, a change of 10-20 points is considered clinically significant.

It is important to note that there are no universally accepted "normal" results for the HOOS, as the scores are dependent on the patient's individual circumstances. Instead, the HOOS scores are used to track changes in the patient's function and quality of life over time and to evaluate the effectiveness of interventions.

References:

1. Nilsdotter AK, Lohmander LS, Klässbo M, Roos EM. Hip disability and osteoarthritis outcome score (HOOS)--validity and responsiveness in total hip replacement. BMC Musculoskelet Disord. 2003 Dec;4:10. doi: 10.1186/1471-2474-4-10. PMID: 14653954; PMCID: PMC317296.
2. Garellick G, Malchau H, Herberts P. Specific or general health outcome measures in the evaluation of total hip replacement. J Bone Joint Surg Br. 2002 Mar;84(2):174-6. doi: 10.1302/0301-620X.84B2.11887. PMID: 11922367.
3. Lyman S, Lee YY, Franklin PD, Li W, Cross MB, Padgett DE. Validation of the HOOS, JR: a short-form hip replacement survey. Clin Orthop Relat Res. 2016 Feb;474(2):147-53. doi: 10.1007/s11999-015-4362-2. Epub 2015 Sep 25. PMID: 26407690; PMCID: PMC4718582.