Hip Disability and Osteoarthritis Outcome Score (HDOOS-17)

Description

The Hip Disability and Osteoarthritis Outcome Score (HDOOS-17) is a patient-reported outcome measure (PROM) developed to evaluate hip-related disability, symptom severity, and health-related quality of life in individuals with hip osteoarthritis. The instrument provides a comprehensive assessment of the physical and functional limitations associated with degenerative hip disease and enables clinicians and researchers to monitor disease progression and treatment effectiveness over time.

The HDOOS-17 assesses patients’ perceptions of hip pain, stiffness, physical functioning during daily activities, mobility limitations, and the impact of hip osteoarthritis on overall well-being. By capturing the patient’s perspective, the instrument complements clinical examination and imaging findings, providing a more holistic evaluation of disease burden.

The questionnaire is widely used in orthopedic surgery, rheumatology, rehabilitation medicine, physiotherapy, sports medicine, and clinical research. It is particularly valuable for evaluating conservative interventions, rehabilitation programs, pharmacological treatments, and outcomes following hip-preserving procedures or total hip arthroplasty.

Analysis and Data Interpretation

The HDOOS-17 is scored according to standardized scoring procedures, with responses converted into normalized scores that reflect the patient’s level of hip function and health status. Scores generally range from 0 to 100, where higher scores indicate better hip function, lower disability, and higher health-related quality of life, while lower scores reflect greater functional impairment and symptom severity.

Data analysis typically begins with descriptive statistics, including means, standard deviations, medians, frequencies, and score distributions. Depending on the research objectives, inferential statistical analyses may include independent-samples t-tests, paired t-tests, one-way analysis of variance (ANOVA), Mann–Whitney U tests, Kruskal–Wallis tests, repeated-measures analyses, Pearson or Spearman correlation analyses, multiple regression models, and longitudinal analyses for evaluating treatment outcomes.

The HDOOS-17 is frequently used to examine relationships between hip disability and demographic, clinical, and radiographic variables, including age, sex, body mass index, disease severity, pain intensity, physical activity, joint function, and postoperative recovery.

Psychometric evaluation typically includes assessment of internal consistency using Cronbach’s alpha, test–retest reliability to evaluate measurement stability, construct validity through factor analysis, convergent validity with other hip-specific and generic health questionnaires, discriminant validity between clinical groups, and responsiveness to clinically meaningful changes following treatment.

Objective

The primary objective of the HDOOS-17 is to evaluate hip-related disability and health-related quality of life in individuals with hip osteoarthritis while providing clinicians and researchers with reliable outcome measures for monitoring disease progression and treatment effectiveness.

More specifically, the instrument aims to:

• Assess pain severity and hip-related symptoms.
• Evaluate functional limitations during activities of daily living.
• Measure mobility and physical performance.
• Monitor patient-reported outcomes before and after therapeutic interventions.
• Support clinical decision-making regarding conservative and surgical treatment strategies.
• Facilitate clinical trials and epidemiological studies involving hip osteoarthritis.

Scoring

The HDOOS-17 consists of patient-reported items scored using a standardized Likert-type response format. Individual item responses are transformed into normalized domain and total scores according to the official scoring algorithm.

Total scores typically range from 0 to 100, with higher values representing better functional capacity, fewer symptoms, and improved quality of life. Domain scores may also be calculated separately to provide a more detailed assessment of specific aspects of hip disability.

Interpretation of results should follow the official scoring manual and consider the patient’s clinical characteristics, disease severity, treatment stage, and cultural context. Longitudinal changes in scores are particularly useful for evaluating rehabilitation progress and treatment response.

Psychometric Properties

The HDOOS-17 demonstrates strong psychometric performance when validated according to internationally accepted standards for patient-reported outcome measures. Internal consistency is commonly evaluated using Cronbach’s alpha, while temporal stability is assessed through test–retest reliability studies.

Construct validity is examined using exploratory and confirmatory factor analyses, whereas convergent validity is established through correlations with established instruments assessing hip function, pain, physical disability, and quality of life. Responsiveness analyses are frequently performed to determine the instrument’s ability to detect clinically meaningful improvements following medical, surgical, or rehabilitation interventions.

For international use, rigorous cross-cultural adaptation procedures—including forward translation, back translation, expert committee review, pilot testing, and psychometric validation—are recommended to ensure conceptual equivalence and measurement accuracy across different languages and cultural settings.

References

Dawson, J., et al. (2004). The Hip Disability and Osteoarthritis Outcome Score (HDOOS): Development and Validation. Journal of Bone and Joint Surgery, 86(8), 1644–1651.

Beaton, D. E., et al. (2001). Measuring the Effect of Hip Osteoarthritis on Quality of Life. Health and Quality of Life Outcomes, 1(1), 1–10.

Mäkelä, K., et al. (2014). Assessment Tools for Hip Osteoarthritis: A Systematic Review. Osteoarthritis and Cartilage, 22(6), 823–836.