Oxford Hip Score (OHS)
The Oxford Hip Scores (OHS) has been used extensively since it was first described in 1996. Over time, it has been modified and used for a variety of different purposes, but the primary goal during development of the OHS was to assess pain and function in patients undergoing Total Hip Arthroplasty (THA).
The Oxford Hip Score is used worldwide and has been translated into a number of different languages. In addition, it has also been utilized in many controlled trials, cohort studies and audits. Apart from its utility in evaluating patients following a THA, the OHS is also used for the assessment of patients following alternative non-surgical interventions such as physical therapy, joint supplements and anti-inflammatory medications.
The Oxford Hip Score questionnaire is a short, 12-item survey with a recall period of four weeks. It assesses pain and function of the hip in relation to daily activities such as walking, dressing, climbing the stairs and sleeping. Each item has five possible responses (least difficult to most difficult) and items are summed to give a score from 12-60. Higher scores represent better functionality.
The Oxford Hip Score is short, reproducible and extensively referenced in orthopedic literature.
It has been demonstrated to be highly sensitive to change in patients undergoing primary THA and revision THA. The responsiveness of the OHS to change has been found to be greater than generic measures such as the SF-36 and disease specific measures such as the WOMAC.
The Oxford Hip Survey has a number of considerations that have been brought up by some researchers. Because OHS was designed as a site-specific outcome measure, patients may have some difficulty discriminating between pain and disability from the affected joint and that arising from an existing comorbidity.
Secondly, the OHS survey contains a number of double-barreled questions. This refers to when a single question is posed in such a way that it appears to be two questions in one . For example, one of the questions included in the OHS asks “Have you had any trouble getting in and out of a car or using public transport because of your hip?” This may pose difficult for a patient to answer because they may have problems getting out of their car but no problems with using public transit which leads to ambiguity on how to respond. During psychometric testing of an instrument it is always advisable to remove all double-barreled questions but unfortunately they still exist in the OHS.
In 2021, a study was done to investigate the current validity of the OHS given that it was developed more than 20 years ago. Within this study, it was found that there are several items that present-day patients deem relevant that are not included in the OHS.
Despite these considerations, the Oxford Hip Score is a validated and popular measure that has been used in large registry studies. It is quick to complete and easy to score. However, it is important to review the tools considerations prior to implementing it.
Licensing and Cost
The Oxford Hip Score requires a license to be utilized and requires a fee for certain populations. To learn more about the Oxford Hip Score, please visit their website: https://innovation.ox.ac.uk/outcome-measures/oxford-hip-score-ohs/.
The Oxford hip score: the patient’s perspective | 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