Melbourne Hip Surgeon Parminder J Singh uses the Oxford hip score (OHS) which is a joint specific outcome measure tool designed to assess disability in patients suffering from hip pain secondary to arthritis.
The OHS range between zero and 48 points (where zero indicates the most severe problems and higher values indicate better function). The OHS has been shown to be validated measures of pre-surgery disease state and outcomes of hip replacement.
Patients should be referred to specialist to be assessed for a possible hip replacement when pain persists after non-operative care management
Previous studies have introduced guidelines for referral that have included a maximum pre-surgery OHS, set as a threshold that acts as hard boundary for referral to a specialist or not. The thresholds have varied between 18 and 30 points. Recently the Oxford group published research in 2020 to support the use of score thresholds and provided some evidence-based guidance for the selection of threshold levels.
The upper pre-surgery score threshold, above which individual are less likely to achieve any meaningful benefit from surgery, is 40 for hips. At lower scores, the likelihood of improvement increases towards a maximum of 95% for hips. This evidence should protect patients against undergoing surgery that is unlikely to be of value.
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