Hip Outcome Score
Assess functional limitations related to hip pathology, specifically in active individuals undergoing surgery.
Provided by
EVAL FoundationInstructions
For each activity listed, indicate the degree of difficulty you experienced due to your hip condition in the last week.
If the activity in question is limited by something other than your hip, mark not applicable (N/A).
Affected Hip
Overview:
The HOS is a patient-reported outcome measure developed specifically to evaluate functional limitations in individuals with hip pathology, with a focus on those active enough to be candidates for surgical intervention such as hip arthroscopy. It was designed to be more sensitive to higher levels of function than older hip scales like the Harris Hip Score.
Structure:
The HOS consists of two sub-scales:
1. Activities of Daily Living (ADL) Sub-scale
Contains 19 items assessing basic functional tasks such as standing, walking on level surfaces, going up and down stairs, putting on shoes and socks, and sitting
Reflects everyday, lower-demand functional activities
2. Sport Sub-scale
Contains 9 items assessing higher-demand activities such as running, cutting, jumping, landing, starting and stopping quickly, and sport-specific movements
Reflects the more dynamic, athletic demands relevant to active populations
Scoring:
Each item is rated on a 5-point Likert scale:
4 = No difficulty
3 = Slight difficulty
2 = Moderate difficulty
1 = Extreme difficulty
0 = Unable to do
Additionally, patients can mark items as "not applicable" if they do not perform that activity, and those items are excluded from scoring.
Score calculation:
The total number of points earned is divided by the maximum possible points (excluding N/A items), then multiplied by 100
This yields a percentage score from 0–100 for each sub-scale
Higher scores indicate better function
The two sub-scales are reported separately rather than as a combined total score.
Strengths:
Sensitive to higher levels of function relevant to younger, active patients
Original Literature:
Martin, RobRoy L., Bryan T. Kelly, and Marc J. Philippon. "Evidence of validity for the hip outcome score." Arthroscopy 22.12 (2006): 1304-1311.
Validation Literature:
Thorborg, K., et al. "Patient-Reported Outcome (PRO) questionnaires for young to middle-aged adults with hip and groin disability: a systematic review of the clinimetric evidence." Br J Sports Med (2015): bjsports-2014.
Additional Literature:
Chahal, Jaskarndip, et al. "The patient acceptable symptomatic state for the modified Harris Hip Score and Hip Outcome Score among patients undergoing surgical treatment for femoroacetabular impingement." The American journal of sports medicine 43.8 (2015): 1844-1849.
All questions & possible results
Affected Hip
Affected Hip
Select one option:
- Right
- Left
Activities of Daily Living Scale: Part I
Because of your hip, how much difficulty do you have with:
Indicate the degree of difficulty you experienced due to your hip condition in the last week.
If the activity in question is limited by something other than your hip, mark not applicable (N/A).
1. Standing for 15 minutes
Select one option:
- None at all
- Slight
- Moderate
- Extreme
- Unable to do
- N/A
2. Getting into and out of an average car
Select one option:
- None at all
- Slight
- Moderate
- Extreme
- Unable to do
- N/A
3. Walking up steep hills
Select one option:
- None at all
- Slight
- Moderate
- Extreme
- Unable to do
- N/A
4. Walking down steep hills
Select one option:
- None at all
- Slight
- Moderate
- Extreme
- Unable to do
- N/A
5. Going up 1 flight of stairs
Select one option:
- None at all
- Slight
- Moderate
- Extreme
- Unable to do
- N/A
6. Going down 1 flight of stairs
Select one option:
- None at all
- Slight
- Moderate
- Extreme
- Unable to do
- N/A
7. Stepping up and down curbs
Select one option:
- None at all
- Slight
- Moderate
- Extreme
- Unable to do
- N/A
8. Deep squatting
Select one option:
- None at all
- Slight
- Moderate
- Extreme
- Unable to do
- N/A
9. Getting into and out of a bath tub
Select one option:
- None at all
- Slight
- Moderate
- Extreme
- Unable to do
- N/A
10. Walking initially
Select one option:
- None at all
- Slight
- Moderate
- Extreme
- Unable to do
- N/A
11. Walking for approximately 10 minutes
Select one option:
- None at all
- Slight
- Moderate
- Extreme
- Unable to do
- N/A
12. Walking 15 minutes or greater
Select one option:
- None at all
- Slight
- Moderate
- Extreme
- Unable to do
- N/A
13. Twisting/pivoting on involved leg
Select one option:
- None at all
- Slight
- Moderate
- Extreme
- Unable to do
- N/A
14. Rolling over in bed
Select one option:
- None at all
- Slight
- Moderate
- Extreme
- Unable to do
- N/A
15. Light to moderate work (standing, walking)
Select one option:
- None at all
- Slight
- Moderate
- Extreme
- Unable to do
- N/A
16. Heavy work (push/pulling, climbing, carrying)
Select one option:
- None at all
- Slight
- Moderate
- Extreme
- Unable to do
- N/A
17. Recreational activities
Select one option:
- None at all
- Slight
- Moderate
- Extreme
- Unable to do
- N/A
Activities of Daily Living Scale: Part II
Because of your hip, how much difficulty do you have with:
18. Putting on socks and shoes (not scored)
Select one option:
- None at all
- Slight
- Moderate
- Extreme
- Unable to do
- N/A
19. Sitting for 15 minutes (not scored)
Select one option:
- None at all
- Slight
- Moderate
- Extreme
- Unable to do
- N/A
Activities of Daily Living Scale: Part III
How would you rate your current level of function during your usual activities of daily living from 0 to 100, with 100 being your level of function prior to your hip problem and 0 being the inability to perform any of your usual daily activities?
A number between 0 and 100 (whole numbers), in %.
Sports Scale: Part I
Because of your hip, how much difficulty do you have with:
1. Running one mile
Select one option:
- None at all
- Slight
- Moderate
- Extreme
- Unable to do
- N/A
2. Jumping
Select one option:
- None at all
- Slight
- Moderate
- Extreme
- Unable to do
- N/A
3. Swinging objects like a golf club
Select one option:
- None at all
- Slight
- Moderate
- Extreme
- Unable to do
- N/A
4. Landing
Select one option:
- None at all
- Slight
- Moderate
- Extreme
- Unable to do
- N/A
5. Starting and stopping quickly
Select one option:
- None at all
- Slight
- Moderate
- Extreme
- Unable to do
- N/A
6. Cutting/lateral movements
Select one option:
- None at all
- Slight
- Moderate
- Extreme
- Unable to do
- N/A
7. Low impact activities like fast walking
Select one option:
- None at all
- Slight
- Moderate
- Extreme
- Unable to do
- N/A
8. Ability to perform activity with your normal technique
Select one option:
- None at all
- Slight
- Moderate
- Extreme
- Unable to do
- N/A
9. Ability to participate in your desired sport as long as you would like
Select one option:
- None at all
- Slight
- Moderate
- Extreme
- Unable to do
- N/A
Sports Scale: Part II
How would you rate your current level of function during your sports related activities from 0 to 100, with 100 being your level of function prior to your hip problem and 0 being the inability to perform any of your usual sports activities?
A number between 0 and 100 (whole numbers), in %.
Current Level of Function
How would you rate your current level of function?
Select one option:
- Normal
- Nearly Normal
- Abnormal
- Severely Abnormal
Possible results
Overall Level of Function — Abnormal
Overall Level of Function: Abnormal
Pertinent Positive: Extremely difficult to run one mile
Level of function in daily activities
Higher scores indicate better function
Overall Level of Function — Nearly Normal
Overall Level of Function: Nearly Normal
Level of function in sports activities
Higher scores indicate better function
Level of function in daily activities
Higher scores indicate better function
Level of function in sports activities
Higher scores indicate better function
Hip Outcome Score (Sports)
Higher scores indicate better function
Overall Level of Function — Normal
Overall Level of Function: Normal
Hip Outcome Score (ADLs)
Higher scores indicate better function
Overall Level of Function — Severely Abnormal
Overall Level of Function: Severely Abnormal
Level of function in daily activities
Higher scores indicate better function
Level of function in sports activities
Higher scores indicate better function
Pertinent Positive: Unable to run one mile
Citation
Martin RL, Kelly BT, Philippon MJ. Evidence of validity for the hip outcome score. Arthroscopy. 2006 Dec;22(12):1304-11. doi: 10.1016/j.arthro.2006.07.027. PMID: 17157729.
