Reliability of Modified Harris Hip Score as a tool for outcome evaluation of Total Hip Replacements in Indian population

Abstract

Background: Standard Harris Hip Score (HHS) is a validated tool, to measure the functional status of an individual and has been traditionally used to assess the condition of a patient with hip pathologies. Harris hip score in its standard form includes a physician's physical examination component which has a high inter-observer variability. A modified version of HHS (MHHS) was devised and brought into use, but has not been validated as an outcome measure, post total hip replacement (THR) in Indian population. Methods: 101 patients with 122 hips for whom THR was done, were followed up, and HHS and MHHS were recorded at a minimum followup of 6 months. Results: The mean MHHS was 78.97 with a standard deviation of 15.017. There was positive correlation between the two functional outcome scores with a p value of 0.001. MHHS was found to be reliable with a significant intraclass correlation coefficient (p = 0.001). Conclusion: MHHS is a reliable and valid tool to measure functional outcome in patients undergoing Total Hip Replacements.

Results of advanced core decompression in patients with osteonecrosis of the femoral head depending on age and sex—a prospective cohort study

“…All patients underwent detailed preoperative physical examination and were followed up regularly at the Department of Orthopaedics and Traumatology of the University Hospital Essen. The recorded parameters included the modified Harris Hip Score (mHHS) for evaluation of hip function and the numeric rating scale (NRS) for pain quantification [25,26]. ONFH was treated solely by advanced core decompression (ACD) and its modified version (mACD) between the years 2011 and 2016 as described by Landgraeber et al [17,27].…”

Assessment and reliability of the World Health Organisation quality of life (WHO QOL-BREF) questionnaire in total hip replacement patients

“…1 Radiological and functional outcomes have been used to assess the prognosis of these patients by multiple studies. 1,2,5 Evaluating the multidimensional status of well-being with WHO QOL scores in this important orthopaedic subset was never done previously.…”

“…These scores do not involve clinical examinations and the added advantage of such a patient reported outcome is that the actual presence of the patient is not even needed and the scoring can be done via a telephonic or video conversation. 2,9 This saves time for both the patient and the assessor, latter could not even be a clinical practitioner, who in turn can devote the saved time in clinical practice. 2 Additionally, this could specially help in follow ups of hip arthroplasty patients in these trying times of the Covid-19 pandemic, where routine OPDs are not functioning and the onus is on audio/video consultations.…”

“…2,9 This saves time for both the patient and the assessor, latter could not even be a clinical practitioner, who in turn can devote the saved time in clinical practice. 2 Additionally, this could specially help in follow ups of hip arthroplasty patients in these trying times of the Covid-19 pandemic, where routine OPDs are not functioning and the onus is on audio/video consultations. Although another patient reported and validated tool, the Modified Harris Hip score, also does not need clinical examination, it only assesses pain and functional status of the patients; a score like WHO QOL-BREF, encompasses every possible prognostic domain of well being, be it physical or socio-psychological.…”

“…1,3 Various scoring tools are available to evaluate the outcomes in hip surgeries; Harris Hip score (HHS), Oxford Hip scores, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Modified Harris Hip Score. 2,5 Majority of these scores were devised in western countries and their cross-cultural compatibilities are unclear. 8 QOL assessment in postoperative patients is not routinely done, probably due to non-availability of a suitable instrument.…”