What is the Harris Hip Score?

The Harris Hip Score (HHS) is a widely recognized clinical instrument used to assess the outcomes of hip surgery and various hip disabilities in adults. Developed in 1969 by Dr. William H. Harris, it remains a gold standard for evaluating functional success after total hip arthroplasty (THA), femoral neck fractures, and management of hip osteoarthritis.

HHS Domains and Scoring Mechanism

The calculator utilizes a 100-point scale divided into four specific domains to provide a comprehensive view of patient function and comfort:

• Pain (44 points): Evaluates the severity of pain and its impact on the patient's daily life and medication requirements.
• Function (47 points): Split between gait (limp, support, distance) and activities of daily living (stairs, socks/shoes, sitting, public transport).
• Absence of Deformity (4 points): Awarded for meeting specific clinical criteria (flexion contracture < 30°, fixed abduction < 10°, internal rotation < 10°, and limb length discrepancy < 3.2 cm).
• Range of Motion (5 points): Calculated based on degrees of flexion, abduction, adduction, and rotation.

Interpreting the HHS Results

Clinical outcomes are categorized based on the total score:

• 90 – 100: Excellent
• 80 – 89: Good
• 70 – 79: Fair
• Below 70: Poor

Modified Harris Hip Score (mHHS)

The Modified Harris Hip Score (mHHS) is a derivative that excludes the physical examination components (Deformity and ROM), relying solely on patient-reported data for pain and function. This version is particularly useful for remote monitoring and tele-health follow-ups.

Clinical Validity and References

The HHS has demonstrated high inter-rater reliability (r = 0.94) and is highly responsive to clinical changes in the early post-operative period. However, clinicians should be aware of "ceiling effects" in high-functioning patients long-term.