Hip disability and osteoarthritis outcome score (HOOS)--validity and responsiveness in total hip replacement.

Anna K Nilsdotter,Maria Klässbo,L Stefan Lohmander,Ewa M Roos

doi:10.1186/1471-2474-4-10

Abstract

BackgroundThe aim of the study was to evaluate if physical functions usually associated with a younger population were of importance for an older population, and to construct an outcome measure for hip osteoarthritis with improved responsiveness compared to the Western Ontario McMaster osteoarthritis score (WOMAC LK 3.0).MethodsA 40 item questionnaire (hip disability and osteoarthritis outcome score, HOOS) was constructed to assess patient-relevant outcomes in five separate subscales (pain, symptoms, activity of daily living, sport and recreation function and hip related quality of life). The HOOS contains all WOMAC LK 3.0 questions in unchanged form. The HOOS was distributed to 90 patients with primary hip osteoarthritis (mean age 71.5, range 49–85, 41 females) assigned for total hip replacement for osteoarthritis preoperatively and at six months follow-up.ResultsThe HOOS met set criteria of validity and responsiveness. It was more responsive than WOMAC regarding the subscales pain (SRM 2.11 vs. 1.83) and other symptoms (SRM 1.83 vs. 1.28). The responsiveness (SRM) for the two added subscales sport and recreation and quality of life were 1.29 and 1.65, respectively. Patients ≤ 66 years of age (range 49–66) reported higher responsiveness in all five subscales than patients >66 years of age (range 67–85) (Pain SRM 2.60 vs. 1.97, other symptoms SRM 3.0 vs. 1.60, activity of daily living SRM 2.51 vs. 1.52, sport and recreation function SRM 1.53 vs. 1.21 and hip related quality of life SRM 1.95 vs. 1.57).ConclusionThe HOOS 2.0 appears to be useful for the evaluation of patient-relevant outcome after THR and is more responsive than the WOMAC LK 3.0. The added subscales sport and recreation function and hip related quality of life were highly responsive for this group of patients, with the responsiveness being highest for those younger than 66.

Highlights

Some 20 different scores have been introduced to evaluate the results of total hip replacement (THR) [1]
KOOS, Knee Injury and Osteoarthritis Outcome score [11] is a further development of WOMAC initially constructed as a measure of patient-relevant outcomes to be used in studies of the treatment of anterior cruciate ligament and meniscus injury
HOOS The HOOS is an adaptation of the KOOS [11,13] intended to evaluate symptoms and functional limitations related to the hip

Summary

Introduction

Some 20 different scores have been introduced to evaluate the results of total hip replacement (THR) [1]. KOOS, Knee Injury and Osteoarthritis Outcome score [11] is a further development of WOMAC initially constructed as a measure of patient-relevant outcomes to be used in studies of the treatment of anterior cruciate ligament and meniscus injury. Many patients eligible for THR have expectations of more demanding physical functions than required for activities of daily living This encouraged us to study the use of an adapted form of KOOS in patients receiving a total hip replacement for OA. The aim of the study was to evaluate if physical functions usually associated with a younger population were of importance for an older population, and to construct an outcome measure for hip osteoarthritis with improved responsiveness compared to the Western Ontario McMaster osteoarthritis score (WOMAC LK 3.0)

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