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Henrik Malchau - One of the best experts on this subject based on the ideXlab platform.
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the patient acceptable symptom state for the Harris Hip Score following total Hip arthroplasty validated thresholds at 3 month 1 3 5 and 7 year follow up
Journal of Arthroplasty, 2020Co-Authors: Vincent P Galea, Henrik Malchau, Isabella Florissi, Pakdee Rojanasopondist, James W Connelly, Lina Holm Ingelsrud, Charles R Bragdon, Anders TroelsenAbstract:Abstract Background The Patient Acceptable Symptom State (PASS) represents the value on a patient-reported outcome measure (PROM) scale beyond which patients consider themselves well or in a satisfactory state. PASS values for the Harris Hip Score (HHS) after total Hip arthroplasty (THA) are currently lacking. The aim of this study was to define and validate the PASS threshold for the HHS at 3 months, 1, 3, 5, and 7 years after THA. Methods A total of 976 patients from 14 centers in 7 countries were enrolled into a prospective study. Patients completed the HHS and a 21-point numerical rating scale (NRS) for satisfaction at each follow-up interval. PASS thresholds for the HHS were calculated at each follow-up interval using the anchor-based, 80% specificity method. Satisfaction from the NRS served as the anchor. A bootstrapping method was used to internally validate the primary PASS thresholds. External validation was also conducted on patients sourced from the institutional registry of a tertiary academic medical center. Results Based on receiver operator characteristics analysis, the HHS was an excellent predictor of satisfaction at each time point (area under the curve (AUC)>0.8; p Conclusion The current study is the first to present validated PASS thresholds for the HHS at 3 months, 1, 3, 5, and 7 years following THA. These findings will serve as a useful reference for future THA outcome studies and as benchmarks for surgeons in their assessment of their patients’ clinical success.
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is the Harris Hip Score system useful to study the outcome of total Hip replacement
Clinical Orthopaedics and Related Research, 2001Co-Authors: Peter Soderman, Henrik MalchauAbstract:Although the Harris Hip Score frequently is used to assess the outcome of total Hip replacement, only a few minor validity tests have been presented. The aim of this study was to perform a validity test of the Harris Hip Score and to test its reliability. Two cohorts were studied. First, 58 patients who had undergone total Hip replacement 2 to 10 years earlier were evaluated by an orthopaedic surgeon and an experienced physiotherapist using the Harris Hip Score. The patients also answered the Western Ontario and McMaster University Osteoarthritis Index and the Medical Outcomes Study 36-Item Short-Form Health Survey. Second, 1056 patients answered the Western Ontario and McMaster University Osteoarthritis Index and the Medical Outcomes Study 36-Item Short-Form Health Survey questionnaires. The results were compared with those of a subcohort of 344 patients who were evaluated using the Harris Hip Score. The following items were tested: content validity, convergent and divergent construct validity, criterion validity, test and retest reliability, internal consistency reliability, and interobserver reliability. The Medical Outcomes Study 36-Item Short-Form Health Survey, Western Ontario and McMaster University Osteoarthritis Index, and the Harris Hip Score showed high validity and reliability. The Harris Hip Score can be used by a physician or a physiotherapist to study the clinical outcome of Hip replacement.
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specific or general health outcome measures in the evaluation of total Hip replacement a comparison between the Harris Hip Score and the nottingham health profile
Journal of Bone and Joint Surgery-british Volume, 1998Co-Authors: Goran Garellick, Henrik Malchau, Peter HerbertsAbstract:We assessed 100 patients with a primary total Hip replacement using the Harris Hip Score and the Nottingham Health Profile at one, three and five years after operation. They were derived from two prospective randomised series of cemented and uncemented replacements. Both scoring systems correlated highly and were each heavily influenced by the system of functional classification defined by Charnley. After five years both reflected the function of the implant and the general state of the patient. A higher degree of sensitivity is needed to show differences in the performance of an implant in the short and medium term. We do not yet have an ideal system of clinical assessment and the overall function must always be properly assessed.
Michael J Salata - One of the best experts on this subject based on the ideXlab platform.
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the patient acceptable symptomatic state for the modified Harris Hip Score and Hip outcome Score among patients undergoing surgical treatment for femoroacetabular impingement
American Journal of Sports Medicine, 2015Co-Authors: Jaskarndip Chahal, Geoffrey S Van Thiel, Richard C Mather, Sang Hoon Song, Aileen M Davis, Michael J SalataAbstract:Background:There is minimal information available on the threshold at which patients consider themselves to be well for patient-reported outcome measures used in patients treated with Hip arthroscopy for femoroacetabular impingement (FAI).Purpose:To determine the patient acceptable symptomatic state (PASS) for the modified Harris Hip Score (mHHS) and the Hip Outcome Score (HOS) in patients with FAI treated with arthroscopic Hip surgery.Study Design:Cohort study (diagnosis); Level of evidence, 2.Methods:A consecutive series of patients at a single institution with FAI who were treated with arthroscopic labral surgery, acetabular rim trimming, and femoral osteochondroplasty were eligible. The mHHS (Score range, 0-100) and the HOS (Score range, 0-100) were administered at baseline and at 12 months postoperatively. An external anchor question at 1 year postoperatively was utilized to determine PASS values: “Taking into account all the activities you have during your daily life, your level of pain, and also yo...
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the minimal clinical important difference mcid and patient acceptable symptomatic state pass for the modified Harris Hip Score and Hip outcome Score among patients undergoing surgical treatment for femoroacetabular impingement
Orthopaedic Journal of Sports Medicine, 2014Co-Authors: Jaskarndip Chahal, Geoffrey S Van Thiel, Richard C Mather, Michael J SalataAbstract:Objectives:The objective of this study was to determine the minimal clinical important difference (MCID) and patient acceptable symptomatic state (PASS) for the modified Harris Hip Score (mHHS) and...
David G Lewallen - One of the best experts on this subject based on the ideXlab platform.
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clinically important improvement thresholds for Harris Hip Score and its ability to predict revision risk after primary total Hip arthroplasty
BMC Musculoskeletal Disorders, 2016Co-Authors: Jasvinder A Singh, Cathy Schleck, Scott Harmsen, David G LewallenAbstract:Some aspects of validity are missing for the Harris Hip Score (HHS). Our objective was to examine the clinically meaningful change thresholds, responsiveness and the predictive ability of the HHS questionnaire. We included a cohort of patients who underwent primary total Hip arthroplasty (THA) and responded to the HHS preoperatively and at 2- or 5-year post-THA (change Score) to examine the clinically meaningful change thresholds (Minimal clinically important improvement, MCII; and moderate improvement), responsiveness (effect size (ES) and standardized response mean (SRM)) based on pre- to post-operative change and the predictive ability of change Score or absolute postoperative Score at 2- and 5-years post-THA for future revision. Two thousand six hundred sixty-seven patients with a mean age of 64 years completed baseline HHS; 1036 completed both baseline and 2-year HHS and 669 both baseline and 5-year HHS. MCII and moderate improvement thresholds ranged 15.9–18 points and 39.6–40.1 points, respectively. ES was 3.12 and 3.02 at 2- and 5-years; respective SRM was 2.73 and 2.52. There were 3195 Hips with HHS Scores at 2-years and 2699 Hips with HHS Scores at 5-years (regardless of the completion of baseline HHS; absolute postoperative Scores). Compared to patients with absolute HHS Scores of 81–100 (Score range, 0–100), patients with Scores 50 points from preoperative to 2-years post-THA, lack of improvement/worsening or 1–20 point improvement were associated with increased hazards of revision, 18.10 (1.41, 234.83; p = 0.02); and 6.21 (0.81, 60.73; p = 0.10), respectively. HHS is a valid measure of THA outcomes and is responsive to change. Both absolute HHS postoperative Scores and HHS Score change postoperatively are predictive of revision risk post-primary THA. We defined MCID and moderate improvement thresholds for HHS in this study.
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clinically important improvement thresholds for Harris Hip Score and its ability to predict revision risk after primary total Hip arthroplasty
Annals of the Rheumatic Diseases, 2016Co-Authors: Jasvinder A Singh, Cathy Schleck, Scott Harmsen, David G LewallenAbstract:Background Some aspects of validity are missing for the Harris Hip Score (HHS). Our objective was to examine the clinically meaningful change thresholds, responsiveness and the predictive ability of the HHS questionnaire.
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ab0757 clinically important improvement thresholds for Harris Hip Score and its ability to predict revision risk after primary total Hip arthroplasty
Annals of the Rheumatic Diseases, 2016Co-Authors: Jasvinder A Singh, Scott Harmsen, C Schelck, David G LewallenAbstract:Background Harris Hip Score (HHS) is the most commonly used instrument in the assessment of total Hip arthroplasty (THA). Clinically meaningful thresholds for HHS have not been defined; limited data exist on responsiveness. Objectives To examine the clinically meaningful change thresholds, responsiveness and predictive ability of the Harris Hip Score (HHS) questionnaire. Methods We included a cohort of patients who underwent primary total Hip arthroplasty (THA) and responded to HHS preoperatively and/or at 2- or 5-year post-THA to examine the clinically meaningful change thresholds (Minimal clinically important improvement, MCII; and moderate improvement), responsiveness (effect size (ES) and standardized response mean (SRM)) based on pre- to post-operative change and its predictive ability at 2- and 5-years post-THA for future revision. Results 2,667 patients with mean age of 64 years completed baseline HHS; 1,036 completed both baseline and 2-year and 669 both baseline and 5-year HHS. MCII and moderate improvement thresholds ranged 15.9–18 points and 39.6–40.1 points, respectively. ES was 3.12 and 3.02 at 2- and 5-years; respective SRM was 2.73 and 2.52. Compared to patients with HHS Scores of 81–100 (Score range, 0–100), patients with Scores 50 points from preoperative to 2-years post-THA, lack of improvement/worsening or 1–20 point improvement were associated with increased hazards of revision, 18.10 (1.41, 234.83; p=0.02); and 6.21 (0.81, 60.73; p=0.10), respectively. Conclusions HHS is a valid measure of THA outcomes, is responsive to change and predictive of revision risk post-primary THA. We have defined MCID and moderate improvement thresholds for HHS in this study. References None Acknowledgement We thank Youlonda Lochler for assisting data extraction from the Mayo Clinic Total Joint Registry. Disclosure of Interest J. Singh Grant/research support from: Savient, Takeda, Consultant for: Savient, Takeda, Regeneron, Iroko, Merz, Bioiberica, Crealta, and Allergan pharmaceuticals, C. Schelck: None declared, S. Harmsen: None declared, D. Lewallen Shareholder of: pipeline, Grant/research support from: DePuy, Stryker, Biomet and Zimmer, Consultant for: Zimmer, Orthosonic and Osteotech
Aileen M Davis - One of the best experts on this subject based on the ideXlab platform.
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the patient acceptable symptomatic state for the modified Harris Hip Score and Hip outcome Score among patients undergoing surgical treatment for femoroacetabular impingement
American Journal of Sports Medicine, 2015Co-Authors: Jaskarndip Chahal, Geoffrey S Van Thiel, Richard C Mather, Sang Hoon Song, Aileen M Davis, Michael J SalataAbstract:Background:There is minimal information available on the threshold at which patients consider themselves to be well for patient-reported outcome measures used in patients treated with Hip arthroscopy for femoroacetabular impingement (FAI).Purpose:To determine the patient acceptable symptomatic state (PASS) for the modified Harris Hip Score (mHHS) and the Hip Outcome Score (HOS) in patients with FAI treated with arthroscopic Hip surgery.Study Design:Cohort study (diagnosis); Level of evidence, 2.Methods:A consecutive series of patients at a single institution with FAI who were treated with arthroscopic labral surgery, acetabular rim trimming, and femoral osteochondroplasty were eligible. The mHHS (Score range, 0-100) and the HOS (Score range, 0-100) were administered at baseline and at 12 months postoperatively. An external anchor question at 1 year postoperatively was utilized to determine PASS values: “Taking into account all the activities you have during your daily life, your level of pain, and also yo...
Pawal Gajendra Prabhakar - One of the best experts on this subject based on the ideXlab platform.
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a prospective observational study of clinical functional and radiological assessment of unstable intertrochanteric fracture of femur in elderly patients treated with proximal femoral nail antirotation using Harris Hip Score
International Journal of Research, 2018Co-Authors: Akshay Jain, Lokesh Gudda Naik, Pawal Gajendra PrabhakarAbstract:Background: The incidence of unstable intertrochanteric fracture in elderly is rising because of increased age and with low bone mineral density. The presence of osteoporosis in intertrochanteric fractures is important because fixation of the proximal fragment depends entirely on the quality of cancellous bone present. The surgical stabilization of unstable intertrochanteric fractures remains a persistent challenge. The purpose of this study is to study the effectiveness and drawbacks of one such newer intramedullary device, Proximal Femoral Nail Antirotation in management of intertrochanteric fractures. Patients and method: After obtaining clearance from hospital ethical board, patients who underwent PFNA for unstable intertrochanteric fractures at a tertiary care center, Mumbai, who have given written and informed consent. Patients fitting into inclusion criteria would form the study group. Sample size was calculated using Post-hoc analysis sample size calculator. Data collected by interviews, observation of clinical and radiological findings and assessment of function done using Harris Hip Score. Categorical data was analyzed by using Chi-square test and comparison of results done using Paired t test. Results: The study comprised of 40 patients, with a mean age of mean age 77± 8.93 years who suffered unstable fracture intertrochanteric femur, due to either trivial fall (82.50%) or RTA (17.50%) and managed by cephalomedullary nailing using Proximal Femoral Nai Antirotation at our centre. Majority of the patients had quality of reduction; Majority of patients took 14 weeks for union with mean union time of 14.2 weeks with standard deviation of ± 1.29. Patients were asked to follow up routinely, with post operative follow up ranging from minimum of 20 weeks to 9 months. At final follow up following results obtained according to Harris Hip Score, were- 45% patients Excellent, 32.50% patients-Good, 20% patients- Fair, 2.50% patients-Poor. Conclusions: The intertrochanteric fracture in elderly patients treated with cephalomedullary nailing using proximal femoral nail-antirotation, which has biomechanical advantage of helical blade providing bone compaction, increasing surface area and better anchorage in femoral head, which showed favorable outcome by retarding rotation and varus collapse and prevents medialization by acting as a central pillar.
