The Harris hip score: Do ceiling effects limit its usefulness in orthopedics?

Figures & data

Flow diagram of data search

Studies included

Authors	Year	Group	Follow–up in years	n	Average HHS	HHS range	SD	Ceiling effect (%)
Lim SJ et al.	2007	dysp	4.8	25	93.8	76–100	8.9	24
Kaneuji A et al.	2007	dysp	15.2	55	89	75–100	5.98	3
Incavo SJ et al.	2007	mix	6.7	143	91	63–100	10.64	20
Saito S et al.	2007	mix	6.4	76	95	91–100	1.89	1
Min BW et al.	2007	mix	7.7	98	92.9	83–99	^b	0
Wangen H et al.	2007	dysp	13	49	88	62–100	11.44	15
León JL et al. #	2007	avn	2.9	24	^a	^a	^a	0
Malizos KN et al.	2007	mix	5	245	94	69–97	^b	0
Lin YC et al.	2007	mix	0.25	85	92	82–100	4.5 ^c	4
Zhang H et al.	2007	avn	1.9	72	92.4	78–100	6.05	10
Yates PJ et al.	2007	mix	11.1	122	86	47–100	15.6	18
Robinson RP	2007	mix	1	69	94	^c	6 ^c	16
Robinson RP	2007	mix	1	92	92	^c	11 ^c	23
Bragdon CR et al.	2007	mix	6.9	244	91.1	37–100	11.9 ^c	23
Flecher X et al.	2007	dysp	10.3	97	93	40–100	21.2	37
Le Duff MJ et al.	2007	mix	6.2	144	90.6	41–100	18.85	31
Le Duff MJ et al.	2007	mix	6.2	626	93.8	38–100	17.86	36
Lusty PJ et al.	2007	mix	6.5	259	95	61–100	11.56	33
Braun A et al.	2007	mix	6.5	37	91	33–100	27.3	37
Ochs U et al.	2007	mix	8.1	66	90.1	58.7–99.9	^b	0
Kohler S et al.	2007	dysp	12.2	98	93	60–100	13.2	30
Leali A et al.	2007	mix	4.3	62	97	87–100	4.4	25
Hing CB et al.	2007	mix	3	227	95.2	47–100	16.39	38
Karatosun V et al.	2007	mix	3	71	93	64–100	12.18	28
Ender SA et al.	2007	mix	5	97	92	63–100	11.6	25
Vassan UT et al.	2007	mix	7	112	89	62–100	10.8	15
Kim YL et al.	2007	other	11	12	82.3	69–92	^b	0
Lian YY et al.	2007	other	7.8	52	91.6	69–100	9.94	11
Parsch D et al.	2007	other	16	43	80	38–100	19.32	15
Guyen O et al.	2007	dysp	3.3	167	83.4	25–100	22.19	22
Akhavan S et al.	2007	dysp	6.2	99	98	86–100	4.8	34
Boyd HS et al.	2007	other	4.3	19	84	53–98	^b	0
Fink B et al.	2007	mix	5.3	214	91.2	^c	13.1 ^c	25
Isaac DL et al.	2007	mix	7.6	45	89	41–100	14.9 ^c	23
Lusty PJ et al.	2007	other	6.7	33	90	78–100	5.76	4
Baumann B et al.	2007	mix	9.5	69	85	^c	13 ^c	12
Baumann B et al.	2007	mix	9.5	37	86	^c	14^c	18
Foucher KC et al.	2007	mix	1	28	95	61–100	17	38
Zhang XL et al.	2007	mix	1.5	27	94.5	92–96	^b	0
Lachiewicz PF et al.	2007	mix	10.5	70	88	44–100	18.48	26
Mazoochian F et al.	2007	mix	7	10	94.4	85–100	4.1 ^c	9
Ito H et al.	2007	other	12	43	80.3	25–100	25.44	22
Nakamura Y et al.	2007	other	6.8	23	93.4	^a	^a	9
Yoon KS et al.	2007	mix	10.7	37	90	72–100	9.12	16
Yoon KS et al.	2007	mix	10.7	38	91	74–100	7.68	10
Cieliński Ł et al.	2007	mix	1	13	87.7	^c	12 ^c	14
Kim YH et al.	2007	avn	11.2	194	91	59–100	11.52	22
Vidyadhara S et al.	2007	avn	4.1	45	96	^c	3 ^c	9
Berend KR et al.	2007	mix	5	1080	88.3	^c	8.3 ^c	8
Grübl A et al.	2007	mix	10	105	92	44–100	19.2	34
Kim KI et al.	2007	other	4.8	58	90	42–100	21.12	32
Harada Y et al.	2007	dysp	8.3	81	87.5	^c	8.6 ^c	7
Jacob HA et al.	2007	mix	12	102	97	92–100	2.0	7
Ha YC et al.	2007	mix	5.5	74	94	82–100	5.04	12
Poggie RA et al.	2007	mix	1	157	93	51–100	15.96	33
Poggie RA et al.	2007	mix	1	315	92	36–100	19.04	34
Amstutz HC et al.	2007	dysp	6	59	92.5	41–100	22.66	37
Angin S et al.	2007	mix	3.8	8	95	82–100	9.5 ^c	30
Habermann B et al.	2006	other	11	15	89	76–100	7.49	7

^a Described per patient.

^b SD not calculated since range shows a ceiling effect of 0%. For instance, a range of 60–98 shows that the maximum score of 100 is not reached in this study; hence, the ceiling effect is 0%.

^c SD given.

dysp: hip dysplasia; mix: mixed group; avn: avascular necrosis of femoral head, fracture, osteotomy. etc.