The Harris Hip Score (HHS) is a long-established instrument for evaluating hip function and the results of hip surgery. This page explains what the Harris Hip Score is, what it measures, the items it contains, how it is scored, and how it is used.
What is the Harris Hip Score?
The Harris Hip Score (HHS) is a 100-point, clinician-administered evaluation of hip disability and treatment outcomes, developed by William H. Harris in 1969 and originally applied to patients following traumatic hip injury. It is one of the most widely used hip outcome measures, especially for evaluating total hip arthroplasty. Unlike purely patient-reported instruments, the HHS combines patient-reported information with clinician-measured findings.
What does the Harris Hip Score measure?
The HHS evaluates four domains: pain, function, absence of deformity, and range of motion. Pain and function are weighted most heavily, reflecting their importance to patients, while deformity and range of motion contribute a smaller number of points.
What items are included in the Harris Hip Score?
The instrument contains ten items grouped into its four domains. Pain is assessed with a single item (up to 44 points). Function covers gait (limp, use of walking supports, and walking distance) and activities such as stair climbing, putting on shoes and socks, sitting, and using public transportation (up to 47 points). Absence of deformity is a single clinician-assessed item (4 points), and range of motion is assessed by the clinician (up to 5 points).
How is the Harris Hip Score scored?
Points from all four domains are summed to produce a total from 0 to 100, where higher scores indicate better hip function and less disability. Results are commonly categorized as excellent (90 to 100), good (80 to 89), fair (70 to 79), and poor (below 70). Because it includes clinician-measured range of motion and deformity, part of the score is objective rather than purely self-reported.
How is the Harris Hip Score used in clinical practice?
Surgeons use the HHS to establish a baseline and to measure improvement after hip procedures such as total hip arthroplasty and fracture treatment. It is quick to administer, has shown consistency and inter- and intra-observer reliability, and remains widely reported in the orthopedic literature, allowing outcomes to be compared across studies.
Strengths and limitations
The HHS's strengths include a long track record, wide adoption, and the combination of subjective and objective inputs. Its limitations include the need for a clinician to measure range of motion and deformity, potential examiner bias in those items, and ceiling effects in high-functioning patients, which has motivated the development of purely patient-reported alternatives such as the HOOS and the Forgotten Joint Score.
Frequently asked questions
What is a good Harris Hip Score? Scores of 90 to 100 are considered excellent and 80 to 89 good; higher scores indicate better hip function.
Is the Harris Hip Score patient-reported? It is primarily clinician-administered and includes clinician-measured range of motion and deformity, so it is not purely patient-reported.
How many points is pain worth on the HHS? Pain contributes up to 44 of the 100 points.
References
- Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. Journal of Bone and Joint Surgery (American). 1969;51(4):737-755.
- Söderman P, Malchau H. Is the Harris hip score system useful to study the outcome of total hip replacement? Clinical Orthopaedics and Related Research. 2001;384:189-197.
- Nilsdotter A, Bremander A. Measures of hip function and symptoms. Arthritis Care & Research. 2011;63(S11):S200-S207.
