Multi-Directional Crosswalk of the Harris Hip Score and the Hip Disability and Osteoarthritis Outcome Score

Background: Despite the popularity of the modified Harris Hip Score (mHHS) to monitor patient-reported outcome measures (PROMs) following Total Hip Arthroplasty (THA) over the last 5 decades, International Joint Registries have recently favoured the Hip disability and Osteoarthritis Outcome Score (HOOS). The ability to convert mHHS collected in historical and ongoing studies would be beneficial to benchmark more recent HOOS reports. Hence, this study aimed to create multi-directional crosswalks between mHHS and HOOS. Methods: Forty-nine patients undergoing primary THA prospectively completed both HHS and HOOS forms pre-operatively and at either 3, 6 and/or 12 months postoperatively. The Equipercentile (EQ) and Linear Regression (LR) crosswalk methodology were used. The Mean Absolute Error (MAE) of the crosswalk-derived scores was established against patient-derived (PD) scores. Results: There was a strong correlation between PD mHHS and HOOS (0.90) and HOOS-12 (0.90). The MAE of mHHS-to-HOOS-12 crosswalk was 10.4 (EQ) and 10.1 (LR). Subcategory activity had a larger contribution towards the error in the crosswalks than pain. Conclusions: This is the first crosswalk to facilitate conversion of mHHS and HOOS scores, which are required in long-term THA quality-assurance and research studies, which often span 2 decades of expected implant survivorship.