Functional Outcomes Following Total Hip Replacement: A Prospective Study of Harris Hip Score Improvement and Predictive Value

Background: Total hip replacement (THR) is one of the most successful reconstructive procedures in orthopaedic surgery and is widely performed for end-stage hip disorders such as avascular necrosis, osteoarthritis, fracture neck of femur, and inflammatory arthropathies. Functional outcome following THR is commonly assessed using the Harris Hip Score (HHS), a validated and reliable measure of pain, function, deformity, and range of motion. However, data regarding the predictive value of preoperative HHS on postoperative recovery remain limited, particularly in rural and tribal populations of central India.

Objectives: To evaluate changes in Harris Hip Score following total hip replacement and to assess the predictive value of preoperative HHS on postoperative functional outcomes.

Methods: A prospective observational study was conducted in the Department of Orthopaedics, Raipur Institute of Medical Sciences, Raipur, Chhattisgarh, India, over a period of 18 months. A total of 79 patients undergoing primary THR were included. Functional outcome was assessed using the Harris Hip Score preoperatively, immediately postoperatively, at 3 months, and at 6 months after surgery. Changes in HHS over time were analyzed, and subgroup analysis was performed according to baseline HHS categories to evaluate its predictive value for postoperative recovery.

Results: The mean age of the study population was 44.16 ± 13.85 years, and 77.2% of patients were male. The mean preoperative HHS was 26.37 ± 6.15, which improved significantly to 39.29 ± 1.52 immediately after surgery, 73.13 ± 2.10 at 3 months, and 84.32 ± 3.03 at 6 months (p < 0.001 for all comparisons). The overall mean improvement in HHS from baseline to 6 months was 57.95 points. Patients with lower baseline HHS demonstrated greater absolute postoperative improvement. Individuals with a preoperative HHS <20 achieved the greatest functional gain, with a mean improvement of 65.55 points at 6 months, compared with 50.60 points among those with baseline HHS >30.

Conclusion: Total hip replacement significantly improves hip function and quality of life in the central Indian population. While preoperative status is a predictor of recovery, even patients with severe baseline impairment achieve remarkable functional gains. These findings support the broader implementation of THR programs in rural and tribal healthcare settings to address the growing burden of end-stage hip disease.