Correlations between the Harris Hip Score and the Visual Analogue Scale in the assessment of total hip replacement in hip dysplasia

Open access


Total hip replacement is one of the most frequently performed orthopaedic interventions that can significantly improve the functional status and the quality of life of patients suffering from hip arthrosis. Recently patient satisfaction and patient-reported results of total hip arthroplasty are increasingly emphasised as important tools for the assessments of these interventions. For patients with arthrosis secondary to hip dysplasia, these evaluations can be more difficult, due to younger age and higher functional demands. In this study we compared the Visual Analogue Scale and the Harris Hip Score in order to determine the correlations between these instruments and analyse the possibility of replacing the Harris Score with the Visual Analogue Scale in evaluating the results of hip surgery in patients with dysplastic hips. Our study included 37 women and 4 men (53 hips), with a mean age of 50.96 years (35-58 years), followed for a mean of 4 years postoperatively. Both assessment instruments were used preoperatively and at the follow-up visits. We observed a positive correlation of the values of the Visual Analogue Scale and the Harris Hip Score both preoperatively and postoperatively, with correlation coefficients of +0.71(P <0.001) and +0.77 (P <0.001) respectively. Given these positive correlations, we assumed that the Visual Analogue Scale could replace the Harris Hip Score in the evaluation of patients after total hip replacement. Still it is recommended to combine the Visual Analogue Scale with objective measurements and radiological examination in order to identify significant postoperative changes.

1. Quintana J.M., Arostegui I., Azkarate J., Goenaga J.I., Elexpe X., Letona J. & Arcelay A. (2000). Evaluation of explicit criteria for total hip joint replacement. Journal of clinical epidemiology. 53(12), 1200-1208.

2. The World Health Organization Quality of Life Assessment (WHOQOL). (1998). Development and general psychometric properties. Social science & medicine. 46(12), 1569-1585.

3. Ahmad M.A., Xypnitos F.N. & Giannoudis P.V. (2011). Measuring hip outcomes: common scales and checklists. Injury. 42(3), 259-264.

4. Xu M., Garbuz D.S., Kuramoto L. & Sobolev B. (2005). Classifying health-related quality of life outcomes of total hip arthroplasty. BMC musculoskeletal disorders. 6, 48.

5. Chapman C.R., Casey K.L., Dubner R., Foley K.M., Gracely R.H. & Reading A.E. (1985). Pain measurement: an overview. Pain. 22(1), 1-31.

6. Knahr K., Kryspin-Exner I., Jagsch R., Freilinger W., Kasparek M. (1998). Evaluating the quality of life before and after implantation of a total hip endoprosthesis. Zeitschrift fur Orthopadie und ihre Grenzgebiete. 136(4), 321-329.

7. Lingard E., Hashimoto H. & Sledge C. (2000). Development of outcome research for total joint arthroplasty. Journal of orthopaedic science: official journal of the Japanese Orthopaedic Association. 5(2), 175-177.

8. Amadio P.C. (1993). Outcomes measurements. The Journal of bone and joint surgery American volume. 75(11), 1583-1584.

9. Lieberman J.R., Dorey F., Shekelle P., Schumacher L., Thomas B.J., Kilgus D.J. & Finerman G.A. (1996). Differences between patients' and physicians' evaluations of outcome after total hip arthroplasty. The Journal of bone and joint surgery American volume. 78(6), 835-838.

10. Wright J.G. & Young N.L. (1997). The patientspecific index: asking patients what they want. The Journal of bone and joint surgery American volume. 79(7), 974-983.

11. Harris W.H. (1969). Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. The Journal of bone and joint surgery American volume. 51(4), 737-755.

12. Fergusson A. & Howarth M. (1931). Slipping of the upper femoral epiphysis. JAMA. (97), 1867-1872.

13. D'Aubigne R.M. & Postel M. (1954). Functional results of hip arthroplasty with acrylic prosthesis. The Journal of bone and joint surgery American volume. 36-A(3), 451-475.

14. Charnley J. (1972). The long-term results of low-friction arthroplasty of the hip performed as a primary intervention. The Journal of bone and joint surgery British volume. 54(1), 61-76.

15. Andersson G. (1972). Hip assessment: a comparison of nine different methods. The Journal of bone and joint surgery British volume. 54(4), 621-625.

16. Shields R.K., Enloe L.J., Evans R.E., Smith K.B. & Steckel S.D. (1995). Reliability, validity, and responsiveness of functional tests in patients with total joint replacement. Physical therapy. 75(3), 169-176; discussion 176-169.

17. Kosinski M., Keller S.D., Ware J.E., Jr., Hatoum H.T. & Kong S.X. (1999). The SF-36 Health Survey as a generic outcome measure in clinical trials of patients with osteoarthritis and rheumatoid arthritis: relative validity of scales in relation to clinical measures of arthritis severity. Medical care. 37(5 Suppl), MS23-39.

18. Wright J.G. & Young N.L. (1997). A comparison of different indices of responsiveness. Journal of clinical epidemiology. 50(3), 239-246.

19. Angst F., Aeschlimann A., Steiner W. & Stucki G. (2001). Responsiveness of the WOMAC osteoarthritis index as compared with the SF-36 in patients with osteoarthritis of the legs undergoing a comprehensive rehabilitation intervention. Annals of the rheumatic diseases. 60(9), 834-840.

20. Bachmeier C.J., March L.M., Cross M.J., Lapsley H.M., Tribe K.L., Courtenay B.G. & Brooks P.M. (2001). Arthritis Cost and Outcome Project Group. A comparison of outcomes in osteoarthritis patients undergoing total hip and knee replacement surgery. Osteoarthritis and cartilage/OARS, Osteoarthritis Research Society. 9(2), 137-146.

21. Anderson J.J., Firschein H.E. & Meenan R.F. (1989). Sensitivity of a health status measure to short-term clinical changes in arthritis. Arthritis and rheumatism. 32(7), 844-850.

22. Davies G.M., Watson D.J. & Bellamy N. (1999). Comparison of the responsiveness and relative effect size of the western Ontario and McMaster Universities Osteoarthritis Index and the short-form Medical Outcomes Study Survey in a randomized, clinical trial of osteoarthritis patients. Arthritis care and research: the official journal of the Arthritis Health Professions Association. 12(3), 172-179.

23. Norman G.R., Stratford P. & Regehr G. (1997). Methodological problems in the retrospective computation of responsiveness to change: the lesson of Cronbach. Journal of clinical epidemiology. 50(8), 869-879.

24. Hoeksma H.L., Van Den Ende C.H., Ronday H.K., Heering A. & Breedveld F.C. (2003). Comparison of the responsiveness of the Harris Hip Score with generic measures for hip function in osteoarthritis of the hip. Annals of the rheumatic diseases. 62(10), 935-938.

25. Guyatt G.H., Townsend M., Berman L.B. & Keller J.L. (1987). A comparison of Likert and visual analogue scales for measuring change in function. Journal of chronic diseases. 40(12), 1129-1133.

26. Haverkamp D., Sierevelt I.N., van den Bekerom M.P., Poolman R.W., van Dijk C.N. & Marti R.K. (2008). The validity of patient satisfaction as single question in outcome measurement of total hip arthroplasty. Journal of long-term effects of medical implants. 18(2), 145-150.

27. Brokelman R.B., van Loon C.J. & Rijnberg W.J. (2003). Patient versus surgeon satisfaction after total hip arthroplasty. The Journal of bone and joint surgery British volume. 85(4), 495-498.

28. Brokelman R.B., Haverkamp D., van Loon C., Hol A., van Kampen A. & Veth R. (2012). The validation of the visual analogue scale for patient satisfaction after total hip arthroplasty. European orthopaedics and traumatology. 3(2), 101-105.

29. de Nies F. & Fidler M.W. (1997). Visual analog scale for the assessment of total hip arthroplasty. The Journal of arthroplasty. 12(4), 416-419.

ARS Medica Tomitana

The Journal of "Ovidius" University of Constanta

Journal Information


All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 175 175 17
PDF Downloads 63 63 4