Oxford Hip Score

Oxford Hip Score

A patient-reported outcome instrument which contains 12 questions on activities of daily living that assess function and residual pain in patients undergoing total hip replacement (THR) surgery. The OHS was designed, developed and validated by workers within Public Health and at the University of Oxford, and is the most evaluated hip-specific measure currently available. It is short, reproducible, valid and sensitive to clinically important changes in patients’ clinical status. Prior to the OHS, only crude measures of surgical failure, such as the need to perform revision surgery, were used to assess patient outcomes. The development of the OHS was driven by the need to conduct more systematic and accurate monitoring of patient outcomes following THR.

Patient reported, thereby minimising potential bias by surgeons assessing the results; short, simple and summative, providing a single number value; can be completed on any medium—paper, computer or platform—facilitating follow-up of large cohorts, as formal clinical assessment requires return visits to hospital.

Oxford Hip Score
1. How would you describe the pain you usually have in your hip?
    None = 4 points; severe = 0 points
2. Have you been troubled by pain from your hip in bed at night?
    No nights = 4 points; every night = 0 points
3. Have you had any sudden, severe pain (shooting, stabbing or spasms) from your affected hip?
    No days = 4 points; every day = 0 points
4. Have you been limping when walking because of your hip?
    Rarely = 4 points; all of the time = 0 points
5. For how long have you been able to walk before the pain in your hip becomes severe (with or without a walking aid)?
No pain for 30+ minutes = 4 points; not at all = 0 points
6. Have you been able to climb a flight of stairs?
Yes, easily = 4 points; no, impossible = 0 points
7. Have you been able to put on a pair of socks, stockings or tights?
    Yes, easily = 4 points; no, impossible = 0 points
8. After a meal (sat at a table), how painful has it been for you to stand up from a chair because of your hip?
Not at all painful = 4 points; unbearable = 0 points
9. Have you had any trouble getting in and out of a car or using public transportation because of your hip?
No trouble at all = 4 points; impossible = 0 points
10. Have you had any trouble with washing and drying yourself (all over) because of your hip?
    No trouble at all = 4 points; impossible = 0 points
11. Could you do the household shopping on your own?
    Yes, easily = 4 points; impossible = 0 points
12. How much has pain from your hip interfered with your usual work, including housework?
    Not at all = 4 points; totally = 0 points

Grading the Oxford Hip Score
0 to 19—May indicate severe hip arthritis. See orthopaedic surgeon.
20 to 29—May indicate moderate to severe hip arthritis. See GP for an assessment and x-ray. Consider seeing orthopaedic surgeon.
30 to 39—May indicate mild to moderate hip arthritis. Consider seeing GP for an assessment and possible x-ray. Patient may benefit from non-surgical treatment—e.g., exercise, weight loss and/or anti-inflammatory medication.
40 to 48—May indicate satisfactory joint function. May not require any formal treatment.
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References in periodicals archive ?
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.
Interestingly, Impellizerri et al compared the validity, reproducibility, and responsiveness of the Oxford Hip Score (OHS) and Hip Outcome Score measurements in patients undergoing surgery for FAI syndrome and concluded that the OHS was an appropriate instrument for pain and function assessment in those status post arthroscopic FAI surgery (47% male and 53 % female patients).
Validity, reproducibility, and responsiveness of the oxford hip score in patients undergoing surgery for femoroacetabular impingement.
In addition to the HOOS, there are other instruments that address hip function, such as the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Oxford Hip Score. These instruments are used to assess the impact of osteoarthritis and potential need for joint replacement and are not directly applicable to athletic populations.
A variety of tools has been described: the Oxford Hip score [13], The McMaster Toronto Arthritis Patient Preference Disability Questionnaire [41], and the Japanese Orthopedic Score [40].
The main outcome measures were hip function at 12 months after surgery, assessed using the Oxford hip score and Harris hip score.
Mean Oxford hip score was 40.4 in the resurfacing group and 38.2 in the total arthroplasty group (estimated treatment effect size 2.23 (-1.52--5.98)).
At a mean follow-up of 2 years (range, 1 to 4 years), the mean Harris hip score (HHS) increased from 51 points (range, 36 to 64 points) before surgery to 91 points (range, 50 to 99 points), and the mean Oxford hip score decreased from 43 points before surgery to 12 points.
Study Results Ghera and Pavan (2) At mean follow-up of 1.7 years (2009) (range, 1-3.5), mean HHS improved from 51 (range, 36-64) pre-operatively to 91 (range, 50-99) and mean Oxford hip score improved from 42.5 pre-operatively to 12.4.
Abbreviations: THA, total hip arthroplasty; RHA, resurfacing hip arthroplasty; OHS, Oxford hip score; UCLA, University of California at Los Angeles Activity Score; HHS, Harris Hip Score, ROM, range of motion; P-M, Postel-Merle-d'Aubigne score; WOMAC, Western Ontario and McMaster Universities Osteoarthritis Index.
(23) Despite studies that suggest decreased blood flow and oxygenation with a posterior approach, McBryde and associates have shown no differences in successful outcomes between the posterolateral and anterolateral approaches when evaluating complications, additional surgery, implant survival, or Oxford hip scores. (24) In the hands of the senior investigator (RHJ), we have not experienced any problems such as avascular necrosis or higher dislocation rates related to the posterior surgical approach.

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