Osteoarthritis is a common condition of the hip that affects millions of adults around the world. It’s a frequent cause of pain, functional disability and reduced quality of life. The Hip Disability and Osteoarthritis Outcome Score (HOOS) is a patient-reported outcome measure (PROM) that is used to evaluate Total Hip Arthroplasty (THA) patients.

The HOOS questionnaire was built upon the Western Ontario and MacMaster Universities Osteoarthritis Index (WOMAC) – an instrument that also measures outcomes in osteoarthritis and following THA. Questions from the WOMAC (LK version 3.0) were used as the basis for the survey and two additional dimensions were added: sport & recreation and hip-related quality of life [1].

To its advantage, however, HOOS has been found to be more responsive than the WOMAC survey [1].

The HOOS is composed of 40 questions and looks at five subscales: Pain (10 items), Symptoms (5 items), Activity of Daily Living (17 items), Sport and Recreation Function (4 items) and Hip Related Quality of Life (4 items). A total score is calculated by using a simple formula to produce a score that ranges from 0-100 with higher scores representing better function.

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Strengths

The survey is easy to administer and relatively easy to score. The questionnaire is self-explanatory, user-friendly and well-represented in literature. Additionally, because HOOS contains questions from the WOMAC, WOMAC scores may be derived from the questionnaire. Interestingly enough, HOOS is said to be more valuable for more active and younger patients than the WOMAC. This is because of the added subscales.

Another advantage of this patient-reported outcome measure is that it may be used over short and long term intervals to assess changes induced by treatment (ie. medication, physical therapy, operation), primary injuries or post-traumatic osteoarthritis [2].

Weaknesses

The survey takes approximately 10-15 minutes to complete, which some patients may find difficult. Overall, it’s is a well-regarded tool for the evaluation of patients following a THA. If the time required to complete the survey isn’t an issue, it’s a solid PRO measure to consider. Recently, a shortened version of the HOOS measure was validated, called the HOOS, JR.

License

The HOOS survey does not require a license and is free to use.


References

  1. Nilsdotter, A. K., Lohmander, L. S., Klässbo, M., & Roos, E. M. (2003). Hip disability and osteoarthritis outcome score (HOOS) – validity and responsiveness in total hip replacement. BMC Musculoskeletal Disorders, 4, 10. http://doi.org/10.1186/1471-2474-4-10, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC161815/
  2. Physiopedia. Hip Disability and Osteoarthritis Outcome Score. http://www.physio-pedia.com/Hip_Disability_and_Osteoarthritis_Outcome_Score
  3. Nilsdotter, A., & Bremander, A. (2011). Measures of hip function and symptoms: Harris hip score (HHS), hip disability and osteoarthritis outcome score, 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), S200-S207. http://onlinelibrary.wiley.com/doi/10.1002/acr.20549/pdf