William Harris, an orthopaedic physician in Massachusetts, developed the Harris HIP score to measure a patient's functioning after hip replacement surgery. The assessment provides a standard score used to assess hip replacement post-surgery recovery and compare patient outcomes across the United States. Eight sections on the HIP are rated by the patient: pain, distance walked, activities, public transportation, support, limp, stairs and sitting. Absence of deformity and range of motion are assessed by the physician based on physical examination of the patient.
- Skill level:
Look at the pain scale. The scale consists of seven descriptions of pain ranging from "none or ignores it," to "Totally disabled, crippled, pain in bed, bedridden." A numerical value is assigned to each statement and the patient receives a score based on the statement chosen. Scores range from zero to 44. The higher the score, the less subjective pain the patient feels. A score of 44 is assigned if the patient indicates pain is absent, moderate but tolerable pain receives a score of 20 and no disabling pain receives a score of zero.
Examine the distance walked scale. This scale ranges from zero if the patient is confined to a bed or chair to 11 if the patient can walk an unlimited distance. A higher score is better.
Note the score on the activities -- shoes, socks scale. This scale has three values. A zero means the patient cannot put on shoes and socks, a 2 means a patient can put on shoes and socks with difficulty and a 4 means a patient can put on shoes and socks with ease. A higher score is better.
Look at the public transportation scale. This is a two item scale. If the patient can use public transportation he gets a score of one and if he cannot, he gets a score of zero. A higher score is better.
Examine the support scale, which ranges in values from zero to 11. A score of zero means the patient uses two crutches or cannot walk, a score of 3 means the patient uses one crutch and a score of 11 means the patient does not need support to walk. A higher score is better.
Note the limp scale, ranging in values from zero to 11. A zero means the patient does not have a limp, an 8 mean the patient has a slight limp and an 11 means the patient has no limp. A higher score is better.
Look at the Stairs scale, which ranges in values from zero to four. A zero means the patient is unable to use stairs while a score of four means the patient can use stairs without a railing. A higher score is better.
Examine the sitting scale. The scale ranges from zero to 5. A zero means the patient is unable to comfortable sit in any chair while a five means the patient can sit in an ordinary chair for an hour. A higher score is better.
Read the score the physician gave on the absence of deformity scale, which is scored at either a zero or a four. A score of four indicates a patient has: fixed flexion contracture of less than -1.11 degrees C, less than ten degrees of fixed abduction, less than ten degrees of fixed internal rotation in extension and less than 3.2-c.m. limb length discrepancy. If any fewer than four of these items apply, a score of zero is given. A higher score is better.
Look at the rating the physician gives on range of motion. The physician will look at the hip's flexion, abduction, adduction, external rotation and internal rotation to assign a range of motion score between zero and five. A score of zero means range of motion is between zero and 30 degrees while a score of 5 indicates range of motion was between 211 and 300 degrees. A higher score is better.
Examine the total score. Total scores are out of 100 and grouped as follows:
90 -- 100 Excellent
80 -- 90 Good
70 -- 79 Fair
60 -- 69 Poor
< 60 Failed
Any score above 60 is acceptable, although the higher the score, the better the patient's overall adjustment after the surgery.
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