Polish adaptation and validation of the hip disability and osteoarthritis outcome score (HOOS) in osteoarthritis patients undergoing total hip replacement

Abstract

Background: The Hip disability and Osteoarthritis Outcome Score (HOOS) is a frequently used patient-reported outcome measure (PROM) for assessment of hip disorders and treatment effects following hip surgery. The objective of the study was to translate and adapt the Hip disability and Osteoarthritis Outcome Score (HOOS) into Polish and to investigate the psychometric properties of the HOOS in patients with osteoarthritis undergoing total hip replacement (THR). Materials and methods: The Polish version of the HOOS was developed according to current guidelines. Patients completed the HOOS, Short Form 36 Health Survey (SF-36), the visual analogue scale (VAS) for pain and the global perceived effect (GPE) scale. Psychometric properties including interpretability (floor/ceiling effects), internal consistency (Cronbach's alpha), test-retest reliability (intra-class correlation coefficient, ICC), convergent construct validity (a priori hypothesized Spearman's correlations between the HOOS subscales, the generic SF-36 measure and the VAS for pain) and responsiveness (effect size, association between the HOOS and GPE scores) were analyzed. Results: The study included 157 patients (mean age 66.8 years, 54% women). Floor effects were found prior to THR for the HOOS subscales Sports and Recreation and Quality of Life. The Cronbach's alpha was over 0.7 for all subscales indicating satisfactory internal consistency. The test-retest reliability was good for the HOOS subscale Pain (0.82) and excellent for all other subscales with ICCs ranging from 0.91 to 0.96. The minimal detectable change ranged from 12.0 to 26.2 on an individual level and from 1.4 to 3.0 on a group level. Seven out of eight a priori hypotheses were confirmed indicating good construct validity. Responsiveness was high since the expected pattern of effect sizes in all subscales was found. Conclusions: The Polish version of the HOOS demonstrated good reliability, validity and responsiveness for use in patient groups having THR.

What is the impact of moderate/severe osteoarthritis on patients’ lives? Insights from a Greek cohort (PONOS study)

“…According to our results, both hip and knee OA patients showed similar subscale pattern of impairment (i.e., most impaired subscale Function in sport and recreation, followed by Hip-or Knee-related QoL). This pattern is consistent with that reported by other European studies [38][39][40][41][42] in symptomatic hip or knee OA patients prior to total JR. Additionally, a quite similar proportion of patients in our study reported the worst possible score ( oor effect) for the aforementioned subscales compared to what has been previously reported in other EU studies in patients with advanced disease [38, [40][41][42]. Importantly, patients with moderate to severe hip/knee OA that experience inadequate pain relief suffered from severe stiffness and functional disability.…”

Short-term patient-reported outcomes following total hip replacement: Is the success picture overrated?

“…Since patient satisfaction has been reported to be highly dependent on preoperative patient expectations [ 50 ] and baseline scores [ 51 ], it is likely that a low preoperative score is associated with greater room for improvement and thus greater patient satisfaction [ 51 ]. Consequently, it is not surprising that patients from our cohort, who generally scored relatively low before THR, reported very high levels of satisfaction [ 28 ].…”

“…The user's guide can be downloaded from www.koos.nu [ 27 ]. The Polish version of the HOOS is considered to be a valid and reliable measure in the assessment of patient-relevant outcome in subjects undergoing THR [ 28 ].…”

Polish Cross-Cultural Adaptation of the Lower Limb Functional Index (LLFI) Demonstrates a Valid Outcome Measure for the Lower Limb Region and Joints

“…Particular examples are available for the knees—Knee Injury and Osteoarthritis Outcome Score—KOOS [ 6 , 7 ], Knee Outcome Survey Activities of Daily Living Scale—KOS-ADLS [ 8 ], and Lysholm’s scale and International Knee Documentation Committee—IKDC [ 9 ]. Recently, a comprehensive Polish validation of the Hip disability and Osteoarthritis Outcome Score (HOOS) was completed [ 10 , 11 ]. Further, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) has been validated for degenerative changes in the hip and knee with WOMAC version-3.1, which is available from the authors’ website ( , page last updated: July 2021) in >80 languages, including Polish [ 12 ].…”