Clinical calculator
Harris Hip Score Calculator
Harris Hip Score
The Harris Hip Score is a 100-point clinician-administered hip assessment combining 44 points for pain, 47 for function, 4 for absence of deformity and 5 for range of motion, where 90 or above is graded excellent and below 70 poor.
What the Harris Hip Score means
Harris Hip Score scores run from 0 to 100, where a higher score is better. The bands below are conventional reporting categories, not diagnostic cut-offs.
- Poor0–69.9
Below 70. Substantial pain or functional limitation; in a post-arthroplasty population this is the range that prompts investigation for a failing reconstruction.
- Fair70–79.9
70 to 79. Meaningful residual symptoms or limitation persisting.
- Good80–89.9
80 to 89. Minor residual symptoms with largely restored function.
- Excellent90–100
90 or above. Little or no pain with essentially normal hip function.
Clinically important thresholds
A change in score only matters if it exceeds the smallest difference patients actually notice. Every threshold below is reported with the population it was derived in — a threshold quoted without its population is not usable.
| Type | Value | Subscale | Population | Follow-up | Source |
|---|---|---|---|---|---|
| MCID | ≈ 18 points | — | Total hip arthroplasty | 12 months | Singh JA 2016 |
| Criterion | ≥ 90 excellent, 80–89 good, 70–79 fair, < 70 poor | — | Conventional interpretation bands | — | Harris WH 1969 |
| Criterion | Pain and function account for 91 of the 100 points | — | Scoring structure | — | Harris WH 1969 |
MCID is the smallest change a patient perceives as meaningful. PASS is the score above which patients consider their state acceptable. SCB is a substantial rather than minimal benefit. MDC is the smallest change exceeding measurement error. Criterion is a published cut-off, definition or performance figure belonging to a classification or decision rule — it is not a change score and should not be read as one.
How the score is calculated
Stated in full so the calculation can be independently checked, and reproduced by hand if needed.
The score totals 100 points across four domains. Pain contributes up to 44 points from a single six-level category. Function contributes up to 47: gait is worth 33 (limp 11, support 11, distance walked 11) and activities are worth 14 (stairs 4, shoes and socks 4, sitting 5, public transport 1). Absence of deformity contributes 4 points, awarded only if all four criteria are met — fixed flexion contracture under 30°, fixed adduction under 10°, fixed internal rotation in extension under 10°, and limb length discrepancy under 3.2 cm. Range of motion contributes 5 points via an index: flexion scores 0–45° × 1.0, 45–90° × 0.6 and 90–110° × 0.3; abduction scores 0–15° × 0.8 and 15–20° × 0.3; adduction scores 0–15° × 0.2; external rotation in extension scores 0–15° × 0.4. Internal rotation and extension carry a multiplier of zero. The summed index is multiplied by 0.05 and capped at 5 points.
Missing data
There is no published substitution rule. Unanswered items contribute zero, so any partial total understates the true score and is reported here as provisional rather than compared against the interpretation bands.
Instrument profile
- Developer
- William H. Harris
- Institution
- Massachusetts General Hospital, Boston
- First published
- 1969
- Response format
- Eight weighted categories, four deformity criteria, and five range-of-motion measurements
- Score range
- 0 to 100
- Direction
- Higher score = better
- Recall period
- Current status
- Completion time
- About 8 minutes
- Age range
- Adults
- Regions
- Hip
- Conditions
- Hip osteoarthritis, Femoral neck fracture, Avascular necrosis, Post-traumatic hip arthritis
- Procedures
- Total hip arthroplasty, Hip resurfacing, Hemiarthroplasty, Osteotomy
- Languages
- English, German, Spanish, Portuguese, Chinese, Turkish
- Observer agreement
- Interobserver ICC typically 0.85–0.95 for the total score
- Validity
- Correlates strongly with the WOMAC and the HOOS, and remains the most widely reported hip arthroplasty outcome measure in the historical literature, which is the main reason to keep using it.
- Reliability
- Highly responsive after arthroplasty but with a pronounced ceiling effect — a large share of successful arthroplasty patients score 90 or above, so it discriminates poorly among good outcomes and is weak in younger, high-demand patients. Scoring also requires a clinician examination, so it cannot be collected by questionnaire alone.
- Ceiling effect
- Marked. Frequently cited as the score’s principal weakness in modern arthroplasty cohorts.
Normative values
Reference values from published cohorts, for comparison against the score you calculated.
| Population | Age | Mean | SD |
|---|---|---|---|
| Pre-operative total hip arthroplasty | — | 40–55 | — |
| One year after uncomplicated total hip arthroplasty | — | 90–95 | — |
When to use the Harris Hip Score
Well suited to
- Total hip arthroplasty outcomes, where the volume of historical literature using it makes results directly comparable.
- Settings where a clinician examination is being performed anyway and objective deformity and range-of-motion findings should feed into the score.
Limitations and poor fits
- Postal or online patient-reported follow-up — deformity and range of motion require an examiner, and "modified" versions that drop them are not the same instrument.
- Young, active or non-arthritic hip populations, where the ceiling effect is severe — the HOOS or Hip Outcome Score discriminate far better.
- When a purely patient-reported measure is required for regulatory or registry purposes.
Harris Hip Score compared with other instruments
Instruments measuring a related construct, with the practical difference between them.
| Instrument | Items | Range | What it adds |
|---|---|---|---|
| HOOS | 40 | 0–100 | The HOOS is a 40-item patient-reported questionnaire that scores hip function as five separate subscales — Symptoms, Pain, Activities of Daily Living, Sport and Recreation, and Hip-related Quality of Life — each from 0 (extreme problems) to 100 (no problems). |
| HOS | 26 | 0–100 | The Hip Outcome Score is a 28-item patient-reported questionnaire for non-arthritic hip conditions that yields two independent percentage scores — an Activities of Daily Living subscale, administered as 19 questions of which 17 are scored, and a 9-item Sports subscale — each running from 0% (unable to perform the listed activities) to 100% (no difficulty at all). |
| LEFS | 20 | 0–80 | The LEFS is a 20-item patient-reported questionnaire that measures difficulty with everyday lower limb activities on a single 0 to 80 scale, where 80 indicates no difficulty and a change of 9 points is the smallest difference patients reliably notice. |
| Oxford Hip Score | 12 | 0–48 | The Oxford Hip Score is a 12-item patient-reported questionnaire about hip pain and everyday function over the past four weeks, each item scored 0 to 4 and summed to a total of 0 to 48 in which 48 represents the best possible hip — it is licensed by Oxford University Innovation, so the item wording is not reproduced here. |
Copyright and permitted use
Published openly because it is the question every clinician and researcher asks before using an instrument, and almost nobody answers it.
The Harris Hip Score was published in full in the Journal of Bone and Joint Surgery in 1969 and is a clinician-administered assessment method rather than a copyrighted patient questionnaire. It is reproduced throughout the orthopaedic literature with no licensing programme attached to it. Any particular printed scoring sheet produced by a vendor or institution is a separate document and is not reproduced here.
References
- Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. Journal of Bone and Joint Surgery (American). 1969.PMID 5783851
- Singh JA, Schleck C, Harmsen S, Lewallen D. Clinically important improvement thresholds for Harris Hip Score and its ability to predict revision risk after primary total hip arthroplasty. BMC Musculoskeletal Disorders. 2016.doi:10.1186/s12891-016-1106-8PMID 27287436
- Nilsdotter A, Bremander A. Measures of hip function and symptoms. Arthritis Care & Research. 2011.doi:10.1002/acr.20549PMID 22588772
Editorial status
Not yet reviewedQueued for clinical review by Sam Tuffun, PT, DPT. Sign-off has not taken place — this is a placeholder assignment, not a completed review.