Skip to main content
Log in

Reliability and validity of the Japanese Orthopaedic Association hip score

  • Original Article
  • Published:
Journal of Orthopaedic Science

Abstract

Background

The Japanese Orthopaedic Association (JOA) hip score has been widely used in Japan as a method to assess hip joint diseases. The JOA hip score consists of four subcategories: pain (Pain), range of motion (ROM), ability to walk (Gait), and activities of daily life (ADL). We present the first report to verify the reliability and validity of the JOA hip score.

Methods

A total of 123 patients with osteoarthritis of a unilateral hip and 29 patients with osteonecrosis of a unilateral hip were investigated. The JOA hip score was recorded by orthopedic surgeons in their offices. On the same day, each patient answered a Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) (Japanese version 1.2) by himself or herself. The SF-36 survey measures eight subscales. The internal-consistency reliability of the JOA hip score was evaluated by Cronbach’s coefficient alpha. The validity of the JOA hip score was tested by Spearman’s correlation coefficients between the four subcategories of the JOA hip score and the eight SF-36 subscales.

Results

When patients with osteoarthritis with conservative treatment were assessed by the JOA hip score, Cronbach’s coefficient alpha was 0.70, demonstrating internal-consistency reliability. However, when the JOA hip score was used for other groups, Cronbach’s coefficient alpha was <0.70, demonstrating the lack of internal-consistency reliability. Significant correlations were observed between Pain and bodily pain (r = 0.63), between Gait and physical functioning (PF) (r = 0.70), and between ADL and PF (r = 0.81), but not in any other combinations.

Conclusions

We found that the JOA hip score is a reliable system only for patients with osteoarthritis of the hip with conservative treatment. The JOA hip score is a scaling system with convergent and discriminant validity for the assessment of physical function and pain.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty: an endresult study using a new method of result evaluation. J Bone Joint Surg Am 1969;51:737–755.

    PubMed  CAS  Google Scholar 

  2. Imura S. The Japanese Orthopaedic Association: evaluation chart of hip joint functions. J Jpn Orthop Assoc 1995;69:864–867.

    Google Scholar 

  3. Bellamy N. Pain assessment in osteoarthritis: experience with the WOMAC osteoarthritis index. Semin Arthritis Rheum 1989;18:14–17.

    Article  PubMed  CAS  Google Scholar 

  4. Dawson J, Fitzpatrick R, Carr A, Murray D. Questionnaire on the perceptions of patients about total hip replacement. J Bone Joint Surg Br 1996;78:185–190.

    PubMed  CAS  Google Scholar 

  5. Ware JE Jr, Sherbourne CD. The MOS 36-item Short-Form Health Survey (SF-36). I. Conceptual framework and item selection. Med Care 1992;30:473–483.

    Article  PubMed  Google Scholar 

  6. Fukuhara S, Bito S, Green J, Hsiao A, Kurokawa K. Translation, adaptation, and validation of the SF-36 Health Survey for use in Japan. J Clin Epidemiol 1998;51:1037–1044.

    Article  PubMed  CAS  Google Scholar 

  7. Fukuhara S, Ware JE Jr, Kosinski M, Wada S, Gandek B. Psychometric and clinical tests of validity of the Japanese SF-36 Health Survey. J Clin Epidemiol 1998;51:1045–1053.

    Article  PubMed  CAS  Google Scholar 

  8. McCarney R, Warner J, Iliffe S, van Haselen R, Griffin M, Fisher P. The Hawthorne effect: a randomised, controlled trial. BMC Med Res Methodol 2007;7:30.

    Article  PubMed  Google Scholar 

  9. Takeda H, Kamogawa J, Sakayama K, Kamada K, Tanaka S, Yamamoto H. Evaluation of clinical prognosis and activities of daily living using functional independence measure in patients with hip fractures. J Orthop Sci 2006;11:584–591.

    Article  PubMed  Google Scholar 

  10. Cronbach LJ, Warrington WG. Time-limit tests: estimating their reliability and degree of speeding. Psychometrika 1951;16:167–188.

    Article  PubMed  CAS  Google Scholar 

  11. Helmstadter GC. Principles of psychological measurement. Upper Saddle River, NJ: Prentice Hall; 1964.

    Google Scholar 

  12. Nunnally JC. Psychometric rheory: 2nd edn. Appl Psychol Meas 1979;3:279–280.

    Article  Google Scholar 

  13. Campbell DT, Fiske DW. Convergent and discriminant validation by the multitrait-multimethod matrix. Psychol Bull 1959;56:81–105.

    Article  PubMed  CAS  Google Scholar 

  14. Burger H, van Daele PL, Odding E, Valkenburg HA, Hofman A, Grobbee DE, et al. Association of radiographically evident osteoarthritis with higher bone mineral density and increased bone loss with age: the Rotterdam Study. Arthritis Rheum 1996;39:81–86.

    Article  PubMed  CAS  Google Scholar 

  15. Oberg U, Oberg T. Worse functional status among old people when admitted for arthroplasty: an evaluation with a new assessment system. Scand J Caring Sci 1996;10:96–102.

    PubMed  CAS  Google Scholar 

  16. Hopman-Rock M, Odding E, Hofman A, Kraaimaat FW, Bijlsma JW. Differences in health status of older adults with pain in the hip or knee only and with additional mobility restricting conditions. J Rheumatol 1997;24:2416–2423.

    PubMed  CAS  Google Scholar 

  17. Hopman-Rock M, Kraaimaat FW, Bijlsma JW. Quality of life in elderly subjects with pain in the hip or knee. Qual Life Res 1997;6:67–76.

    Article  PubMed  CAS  Google Scholar 

  18. McHorney CA, Ware JE Jr, Lu JF, Sherbourne CD. The MOS 36-item Short-Form Health Survey (SF-36). III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Med Care 1994;32:40–66.

    Article  PubMed  CAS  Google Scholar 

  19. Croft P, Lewis M, Wynn Jones C, Coggon D, Cooper C. Health status in patients awaiting hip replacement for osteoarthritis. Rheumatology (Oxf) 2002;41:1001–1007.

    Article  CAS  Google Scholar 

  20. Jinks C, Lewis M, Croft P. Health status after hip or knee arthroplasty. Ann Rheum Dis 2003;62:700–701.

    Article  PubMed  CAS  Google Scholar 

  21. Hisatome T, Yasunaga Y, Tanaka R, Yamasaki T, Ishida O, Ochi M. Natural course of the minimally symptomatic nonoperated hip in patients with bilateral hip dysplasia treated with contralateral rotational acetabular osteotomy. J Orthop Sci 2005;10:574–580.

    Article  PubMed  Google Scholar 

  22. Roux CH, Saraux A, Mazieres B, Pouchot J, Morvan J, Fautrel B, et al. Screening for hip and knee osteoarthritis in the general population: predictive value of a questionnaire and prevalence estimates. Ann Rheum Dis 2008;67:1406–1411.

    Article  PubMed  CAS  Google Scholar 

  23. Xenakis TA, Beris AE, Malizos KK, Koukoubis T, Gelalis J, Soucacos PN. Total hip arthroplasty for avascular necrosis and degenerative osteoarthritis of the hip. Clin Orthop 1997;(341):62–68.

    PubMed  Google Scholar 

  24. Marchese VG, Connolly BH, Able C, Booten AR, Bowen P, Porter BM, et al. Relationships among severity of osteonecrosis, pain, range of motion, and functional mobility in children, adolescents, and young adults with acute lymphoblastic leukemia. Phys Ther 2008;88:341–350.

    PubMed  Google Scholar 

  25. Morita S, Yamamoto H, Hasegawa S, Kawachi S, Shinomiya K. Long-term results of valgus-extension femoral osteotomy for advanced osteoarthritis of the hip. J Bone Joint Surg Br 2000;82:824–829.

    Article  PubMed  CAS  Google Scholar 

  26. Uesugi Y, Makimoto K, Fujita K, Nishii T, Sakai T, Sugano N. Validity and responsiveness of the Oxford hip score in a prospective study with Japanese total hip arthroplasty patients. J Orthop Sci 2009;14:35–39.

    Article  PubMed  Google Scholar 

  27. Roorda LD, Jones CA, Waltz M, Lankhorst GJ, Bouter LM, van der Eijken JW, et al. Satisfactory cross cultural equivalence of the Dutch WOMAC in patients with hip osteoarthritis waiting for arthroplasty. Ann Rheum Dis 2004;63:36–42.

    Article  PubMed  CAS  Google Scholar 

  28. Soderman P, Malchau H. Is the Harris Hip Score system useful to study the outcome of total hip replacement? Clin Orthop 2001;(384):189–197.

    Article  PubMed  Google Scholar 

  29. Pua YH, Wrigley TV, Cowan SM, Bennell KL. Hip flexion range of motion and physical function in hip osteoarthritis: mediating effects of hip extensor strength and pain. Arthritis Rheum 2009;61:633–640.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

About this article

Cite this article

Kuribayashi, M., Takahashi, K.A., Fujioka, M. et al. Reliability and validity of the Japanese Orthopaedic Association hip score. J Orthop Sci 15, 452–458 (2010). https://doi.org/10.1007/s00776-010-1490-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00776-010-1490-0

Keywords

Navigation