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Validity, reliability and responsiveness of patient-reported outcome questionnaires when assessing hip and groin disability: a systematic review
  1. K Thorborg1,
  2. EM Roos2,
  3. EM Bartels3,
  4. J Petersen1,
  5. P Hölmich1
  1. 1Department of Orthopaedic Surgery, Amager Hospital, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
  2. 2Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
  3. 3Copenhagen University Library and The Parker Institute, Copenhagen, Denmark
  1. Correspondence to Kristian Thorborg, Department of Orthopaedic Surgery, Amager Hospital, Faculty of Health Sciences, University of Copenhagen, Italiensvej 1, 2300 Copenhagen S, Denmark; kristian.thorborg{at}


Background Novel treatment interventions are advancing rapidly in the management of hip and groin disability in the physically active young to middle-aged population.

Objective To recommend the most suitable patient-reported outcome (PRO) questionnaires for the assessment of hip and groin disability based on a systematic review of evidence of validity, reliability and responsiveness of these instruments.

Methods MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, PsycINFO, SportsDiscus and Web of Science were all searched up to January 2009. Two reviewers independently rated measurement properties of the PRO questionnaires in the included studies, according to a standardised criteria list.

Results The computerised search identified 2737 publications. Forty-one publications investigating measurement properties of PRO questionnaires assessing hip or groin disability were included in the study. Twelve different questionnaires designed for patients with hip disability and one questionnaire for patients with groin disability were identified. Hip dysfunction and Osteoarthritis Outcome Score (HOOS) contains adequate measurement qualities to evaluate patients with hip osteoarthritis (OA) or total hip replacement (THR). Hip Outcome Score (HOS) is the best available questionnaire for evaluating hip arthroscopy, but the Inguinal Pain Questionnaire, the only identified questionnaire evaluating groin disability, does not contain adequate measurement qualities.

Conclusions HOOS is recommended for evaluating patients with hip OA undergoing non-surgical treatment and surgical interventions such as THR. HOS is recommended for evaluating patients undergoing hip arthroscopy. Current and new PRO questionnaires should also be evaluated in younger patients (age <50) with hip and/or groin disability, including surgical and non-surgical patients.

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  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.