The HOOS, JR. is a short, patient-reported measure of hip health designed for use around hip replacement. This page explains what the HOOS, JR. is, what it measures, the questions it contains, how it is scored, and how it is used.
What is the HOOS, JR.?
The HOOS, JR. (Hip Disability and Osteoarthritis Outcome Score for Joint Replacement) is a six-item, patient-reported outcome measure of hip health. It was derived from the longer 40-item HOOS using Rasch analysis to create a short, joint-specific instrument focused on outcomes after total hip arthroplasty. It is endorsed for hip osteoarthritis outcome tracking and is valued for taking only a few minutes to complete.
What does the HOOS, JR. measure?
The HOOS, JR. captures a single dimension of overall hip health that combines pain and function. It is intended primarily for the pre- and postoperative assessment of patients undergoing hip replacement.
What questions are included in the HOOS, JR.?
The six items include two pain items and four items covering function in daily living. Patients rate items such as pain during activities and difficulty with tasks like getting in and out of a car, rising from sitting, bending to the floor, and walking, based on how their hip has felt over a recent period.
How is the HOOS, JR. scored?
Each item is rated 0 (none), 1 (mild), 2 (moderate), 3 (severe), or 4 (extreme). The six raw item scores are summed (raw range 0 to 24) and then converted to an interval score from 0 to 100 using a published conversion table, where 0 represents total hip disability and 100 represents perfect hip health. If more than two of the six items are missing, the score should not be computed; if one or two are missing, the average of the remaining items is imputed.
How is the HOOS, JR. used in clinical practice?
The HOOS, JR. is used to establish a preoperative baseline and to track change after hip replacement. Its brevity makes it practical for routine collection at multiple time points, and it has demonstrated acceptable internal consistency and high responsiveness, with strong correlation to the FJS-12 at one-year follow-up in hip arthroplasty populations.
Strengths and limitations
Strengths include brevity, ease of scoring, and suitability for high-volume outcome programs. Limitations include a narrower focus than the full HOOS, since it does not separately report symptoms, sport, or quality-of-life subscales, and it is designed for joint-replacement populations rather than every hip condition.
Frequently asked questions
How many questions are on the HOOS, JR.? Six: two pain items and four function items.
What does a HOOS, JR. score of 100 mean? It represents perfect hip health; 0 represents total hip disability.
How is HOOS, JR. different from the full HOOS? The full HOOS has 40 items across five subscales, while the HOOS, JR. is a six-item single-dimension short form.
References
- Lyman S, Lee YY, Franklin PD, Li W, Mayman DJ, Padgett DE. Validation of the HOOS, JR: a short-form hip replacement survey. Clinical Orthopaedics and Related Research. 2016;474(6):1472-1482.
- Nilsdotter AK, Lohmander LS, Klässbo M, Roos EM. Hip disability and osteoarthritis outcome score (HOOS): validity and responsiveness in total hip replacement. BMC Musculoskeletal Disorders. 2003;4:10.
- Hospital for Special Surgery. HOOS, JR. scoring instructions and interval score table.
