Cross-cultural Adaptation and Validation of the Harris Hip Score for Arabic-Speaking Patients

The English language Harris Hip Score (HHS) is widely adopted tool that measures the health of the hip joint through pain, function, and disabilities domains. The aim of this study is to translate the HHS into Arabic (HHS-A) and then assess its validity and reliability.

The HHS-A underwent cross-cultural adaptation involving forward- and backtranslation following recommended guidelines, and then a pilot testing. Validity was assessed by comparing it with the Arabic SF-36 for convergent and divergent validity. Internal consistency was measured using Cronbach's alpha, and test-retest reliability was evaluated with through a subgroup analysis of 20 participants using intraclass correlation coefficients (ICC) and minimal detectable change (MDC).

A total of 149 consecutive patients were enrolled in the study. The mean adjusted total HHS-A score was 45.02 (±17.95), and were 17.15 and 27.87 for pain and function domains, respectively. The pain domain of HHS-A showed strong correlations with physical function (PF) (r = 0.686, P < 0.001) and the physical component summary (PCS) score (r = 0.662, P < 0.001) of the SF-36, while the function domain showed strong correlation with PF (r = 0.742, P < 0.001), and moderate correlation with the physical component summary PCS (r = 0.588, P < 0.001), indicating good convergent validity. A weak correlation was observed between pain domain and the function domain with mental health (r = 0.320, P < 0.001; r = 0.230, P < 0.01, respectively), indicating divergent validity. Both total and function domain demonstrated good internal consistency (Cronbach's alpha: 0.83 and 0.81, respectively). The ICC of the pain and function domains was 0.986 and 0.982, respectively, and the MDC was 3.01 and 3.56 points, respectively.

The Arabic version of the Harris Hip Score is found to be a valid and reliable instrument for assessing hip pathologies within Arabic-speaking populations.