Arthritis of the Hip Evaluation | Medical Algorithm

Description

The Harris score was developed to assess patients with traumatic arthritis of the hip. It can be used to follow patients over time and to help plan management, including the timing for surgical intervention. It can be used to assess patients before and after surgery to determine improvement.

Evaluation:

(1) parameters relevant to the severity of the arthritis are assessed during the history and physical examination

(2) if a concurrent disease is present that causes symptoms which overlap with those of arthritis (distance walked, etc.), the answer should indicate the component expected from the severity of the arthritis

Parameter	Finding	Points
pain	none, or ignores it	44
	slight, occasional, no compromise in activities	40
	mild pain, no effect on average activities, rarely moderate pain with unusual activity, may take aspirin	30
	moderate pain, tolerable but makes concessions to pain; some limitations of ordinary activity or work; may require occasional pain medicine stronger than aspirin	20
	marked pain with serious limitation of activities	10
	totally disabled, crippled, pain in bed, bedridden	0

Class	Parameter	Finding	Points
gait	limp	none	11
		slight	8
		moderate	5
		severe	0
	support	none	11
		cane for long walks	7
		cane most of the time	5
		one crutch	3
		two canes	2
		two crutches	0
		not able to walk	0
	distance walked	unlimited	11
		6 blocks	8
		2-3 blocks	5
		indoors only	2
		bed and chair	0
activities	stairs	normally without using railing	4
		normally using a railing	2
		in any manner	1
		unable to do stairs	0
	shoes & socks	with ease	4
		with difficulty	2
		unable	0
	sitting	comfortably in ordinary chair one hour	5
		on a high chair for one-half hour	3
		unable to sit comfortably in any chair	0
	enter public transportation		1

Absence of Deformity	All of the following must be present	4 points
	less than 30° fixed flexion contracture
	less than 10° fixed adduction
	less than 10° fixed internal rotation in extension
	limb-length discrepancy less than 3.2 centimeters

Degree of Motion	Range	Values	Index Factor
flexion	0 - 45°	0 - 45	1.0
	45 - 90°	0 - 45	0.6
	90-110°	0 - 20	0.3
abduction	0-15°	0 - 15	0.8
	15-20°	0 - 5	0.3
	> 20°		0
external rotation in extension	0-15°	0 - 15	0.4
	> 15°		0
internal rotation in extension	any		0
adduction	0-15°	0 - 15	0.2

overall rating for range of motion =

= (SUM ((value) * (index factor))) * 0.05

Trendelenburg Test	Record As
	positive
	level
	neutral

Harris score =

= (pain value) + (limp value) + (support value) + (distance walked value) + (stairs value) + (shoes value) + (sitting value) + (public transportation value) + (absence of deformity value) + (range of motion value)

Interpretation:

• maximum points 100 (pain 44, function 47, absence of deformity 4, range of motion 5)

• The goal of management is to have a value as close to 100 as possible.

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Description

Specialty

Objective

ICD-10

Arthritis of Hip Evaluation Score

Purpose: To use the Harris score to assess patients with arthritis of the hip.

Description

Specialty

Objective

ICD-10