Hip Disability and Osteoarthritis Outcome Score
Also known as: HOOS, HOOS Scale
The Hip Disability and Osteoarthritis Outcome Score (HOOS) is a patient-reported outcome measure developed to assess pain, symptoms, function, and quality of life in patients with hip osteoarthritis and hip disability. Developed by Nilsdotter and colleagues in 2003, HOOS parallels the structure of KOOS (Knee Injury and Osteoarthritis Outcome Score) but is specifically tailored for the hip joint, making it the reference standard for hip osteoarthritis outcomes in clinical trials and practice.
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When to use it
HOOS is the gold standard measure for patients with hip osteoarthritis or hip disability in orthopedic hip surgery, rheumatology, geriatric medicine, and rehabilitation. Use at baseline to document functional status, during conservative or surgical treatment to monitor progress, and post-intervention (hip arthroplasty or arthroscopy) to quantify outcome. HOOS is particularly valuable in clinical trials evaluating hip arthroscopy, hip replacement, or conservative therapies.
Strengths & limitations
- Multidimensional assessment captures pain, symptoms, daily function, sports participation, and quality of life, providing comprehensive picture of hip disability.
- Validated specifically for hip osteoarthritis and hip disability; more sensitive to hip-specific pathology than generic outcome measures.
- Subscale structure enables identification of specific functional deficits (pain vs. ADL vs. sports limitations) and targeted intervention.
- Available in 50+ languages with strong international validation; referenced in major orthopedic and rheumatologic guidelines.
- Designed for hip conditions; not applicable to other joint disorders or conditions without primary hip pathology.
- Length (40 items) increases patient burden compared to briefer instruments like WOMAC; may reduce compliance in time-limited settings.
- Self-report measure; subject to recall bias, social desirability, and psychological factors that may distort perceived disability.
- Sports/recreation subscale (4 items) is brief and may not fully capture variability in athletic performance across individuals.
Frequently asked
What are the five HOOS subscales and what do they measure?
Pain (10 items) assesses hip pain during activity and rest; Symptoms (5 items) addresses stiffness and swelling; ADL (17 items) evaluates function in walking, stairs, and self-care; Sport/Recreation (4 items) measures ability to participate in sports; QOL (4 items) reflects overall hip-related quality of life impact.
How does HOOS differ from WOMAC?
WOMAC is a general osteoarthritis scale applicable to hip or knee; HOOS is hip-specific with more comprehensive assessment including sports and QOL domains. WOMAC has 24 items and yields a total score; HOOS has 40 items and five separate subscale scores. Use HOOS for detailed hip assessment; WOMAC for brief screening.
What change in HOOS scores indicates clinically meaningful improvement?
A change of 8–10 points per subscale (0–100 scale) represents minimal clinically important difference. Larger change (15–20 points) on ADL and pain subscales typically reflects moderate to substantial improvement. Post-total hip arthroplasty, expect 30–40 point improvement in pain and ADL subscales.
Can HOOS be used in hip osteoarthritis post-operatively or only pre-operatively?
HOOS can and should be used both pre- and post-operatively to document functional baseline and track recovery. Post-operative assessment at 6, 12, and 24 weeks is standard. Some items may require rewording post-operatively to reflect post-surgical context (e.g., pain at surgical site).
Sources
- Nilsdotter, A. K., Lohmander, L. S., Klassbo, M., & Roos, E. M. (2003). Hip Disability and Osteoarthritis Outcome Score (HOOS): development and validation against generic outcome measures in hip osteoarthritis. Arthritis & Rheumatism, 48(11), 3336–3345. link ↗
- Nilsdotter, A. K., Ackermann, P. W., & Roos, E. M. (2007). Scoring instructions and guide for the hip disability and osteoarthritis outcome score (HOOS) v2.0 and HOOS junior. Stockholm, Sweden: Karolinska Institute. link ↗
How to cite this page
ScholarGate. (2026, June 3). Hip Disability and Osteoarthritis Outcome Score. ScholarGate. https://scholargate.app/en/rehabilitation/hoos
Which method?
Set this method beside its closest kin and read them side by side — the library lays the books on the table; the choice is yours.
- Knee Injury and Osteoarthritis Outcome ScoreRehabilitation↔ compare
- WOMAC Osteoarthritis IndexRehabilitation↔ compare