Oxford Hip Score Calculator
Assess hip function and pain using the 12-question Oxford Hip Score questionnaire. Enter values for instant results with step-by-step formulas.
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Each of the 12 questions is scored from 0 (worst/most severe) to 4 (best/no symptoms). Total score ranges from 0 (worst possible) to 48 (best possible hip function). Higher scores indicate better outcomes.
Last reviewed: January 2026
Worked Examples
Example 1: Pre-Operative Hip Replacement Assessment
Example 2: One Year Post-Operative Follow-Up
Background & Theory
The Oxford Hip Score Calculator applies the following established principles and formulas. Health and medicine calculators are grounded in validated physiological measurement methods established through decades of clinical research. Body Mass Index, or BMI, is calculated by dividing weight in kilograms by height in meters squared (kg/m²), a formula originating from Adolphe Quetelet's 19th-century statistical work and later codified by the WHO into standard classifications: underweight below 18.5, normal weight 18.5 to 24.9, overweight 25 to 29.9, and obese at 30 and above. Basal Metabolic Rate quantifies the minimum energy required to sustain life at rest. The Mifflin-St Jeor equation, published in 1990 and widely regarded as the most accurate for most adults, calculates BMR as (10 × weight in kg) + (6.25 × height in cm) − (5 × age) ± sex adjustment. The older Harris-Benedict equations, revised in 1984 by Roza and Shizgal, remain in common use. Total Daily Energy Expenditure is derived by multiplying BMR by a physical activity factor ranging from 1.2 for sedentary individuals to 1.9 for extremely active ones, following the methodology validated by doubly labeled water studies. Body fat percentage can be estimated without laboratory equipment using the U.S. Navy circumference method, which uses neck, waist, and hip measurements, or via BMI-derived equations adjusted for age and sex. The Jackson-Pollock skinfold method offers higher precision with calipers. Blood pressure classification, according to the American College of Cardiology and the 2017 ACC/AHA guidelines, defines normal as below 120/80 mmHg, elevated as 120 to 129 systolic, and hypertension stage 1 as 130 to 139 systolic or 80 to 89 diastolic. Target heart rate zones for aerobic exercise are derived from maximum heart rate estimates, most commonly using the formula 220 minus age in years, with moderate-intensity training typically defined as 50 to 70 percent of maximum heart rate and vigorous intensity at 70 to 85 percent, consistent with CDC and American Heart Association guidelines. These thresholds guide safe and effective cardiovascular conditioning.
History
The history behind the Oxford Hip Score Calculator traces back through the following developments. The history of health measurement stretches back to ancient Greece, where Hippocrates around 400 BCE laid the foundation for observational medicine by systematically recording patient symptoms, diet, and environment. His humoral theory, though scientifically superseded, established the principle that the body operates as an interconnected system subject to measurable imbalance. The transformation toward modern medicine accelerated in the 19th century. Louis Pasteur and Robert Koch developed germ theory in the 1860s and 1870s, identifying microorganisms as disease agents and enabling targeted interventions. Florence Nightingale, working during the Crimean War in the 1850s, introduced statistical analysis to nursing practice, demonstrating through data visualization that sanitation reduced mortality. Her work is foundational to evidence-based health measurement. The discovery of vitamins in the early 20th century, beginning with Casimir Funk's coinage of the term in 1912 and culminating in the isolation of vitamins A through K, created the field of nutritional science and gave rise to dietary reference intake frameworks. The World Health Organization, founded in 1948, subsequently established global standards for health metrics, disease classification through the International Classification of Diseases, and recommended daily allowances. The BMI as a clinical screening tool gained traction in the 1970s through Ancel Keys' large-scale epidemiological work, which validated Quetelet's index as a population-level obesity indicator. Through the 1980s and 1990s, the Framingham Heart Study produced landmark data linking cholesterol, blood pressure, and lifestyle factors to cardiovascular disease risk, directly shaping the numeric thresholds still used in health calculators. The evidence-based medicine movement, formalized by Gordon Guyatt and colleagues at McMaster University in the early 1990s, demanded that all health recommendations derive from systematically graded clinical evidence. The digital health era beginning in the 2000s brought these formulas to consumer devices, wearable sensors, and smartphone applications, expanding access to health self-monitoring on a global scale and enabling population-level data collection that continues to refine clinical reference ranges.
Frequently Asked Questions
Formula
OHS = Sum of 12 items (each scored 0-4)
Each of the 12 questions is scored from 0 (worst/most severe) to 4 (best/no symptoms). Total score ranges from 0 (worst possible) to 48 (best possible hip function). Higher scores indicate better outcomes.
Worked Examples
Example 1: Pre-Operative Hip Replacement Assessment
Problem: A 72-year-old patient with severe hip osteoarthritis is being evaluated for total hip replacement. They experience constant pain, cannot walk more than 15 minutes, need help with socks, and have disturbed sleep due to hip pain every night.
Solution: Pain description: 1 (Moderate-Severe)\nNight pain: 0 (Every night)\nSudden severe pain: 1 (Sometimes)\nLimping: 1 (Most of the time)\nWalking distance: 1 (About 15 minutes)\nClimb stairs: 1 (One step at a time)\nPut on socks: 0 (Cannot do)\nStand from chair: 1 (Very painful)\nUsual work: 1 (Much difficulty)\nTransport: 1 (Moderate difficulty)\nShopping: 1 (With great difficulty)\nStairs down: 1 (One step at a time)\nTotal = 10/48
Result: Oxford Hip Score: 10/48 (Severe arthritis) - Appropriate candidate for hip replacement surgery
Example 2: One Year Post-Operative Follow-Up
Problem: The same patient at one year post total hip replacement reports occasional mild pain, walks over 30 minutes without hip pain, can put on socks independently, sleeps through the night, and has returned to housework and shopping.
Solution: Pain description: 3 (Mild)\nNight pain: 4 (No nights)\nSudden severe pain: 3 (Very rarely)\nLimping: 3 (Rarely)\nWalking distance: 4 (No pain over 30 min)\nClimb stairs: 3 (Mild difficulty)\nPut on socks: 3 (Little difficulty)\nStand from chair: 3 (Slightly painful)\nUsual work: 3 (Little interference)\nTransport: 4 (No trouble)\nShopping: 4 (Easily)\nStairs down: 3 (Mild difficulty)\nTotal = 40/48
Result: Oxford Hip Score: 40/48 (Satisfactory function) - 30-point improvement, excellent surgical outcome
Frequently Asked Questions
What is the Oxford Hip Score and what does it measure?
The Oxford Hip Score (OHS) is a 12-item patient-reported outcome measure specifically designed to assess function and pain in patients undergoing total hip replacement surgery. It was developed at the University of Oxford by Dawson, Fitzpatrick, Carr, and Murray and published alongside the Oxford Knee Score as a companion instrument. Each question is scored from 0 to 4, giving a total score range of 0 (worst possible) to 48 (best possible outcome). The OHS captures the patient perspective on hip function covering activities of daily living, pain levels during various activities, and mobility limitations that are most relevant to hip replacement patients.
How is the Oxford Hip Score calculated and what do the scores mean?
The Oxford Hip Score is calculated by summing the responses to all 12 questions, where each item is scored from 0 (most severe symptoms) to 4 (least symptoms or no problems). The total score ranges from 0 to 48, with higher scores indicating better hip function and less pain in daily activities. Scores of 0 to 19 indicate severe hip arthritis or poor surgical outcome requiring attention, scores of 20 to 29 indicate moderate to severe problems, scores of 30 to 39 suggest mild to moderate difficulties, and scores of 40 to 48 represent satisfactory joint function. The minimal clinically important difference for the OHS is generally considered to be approximately 5 points.
When should the Oxford Hip Score be administered to patients?
The Oxford Hip Score should be administered before hip replacement surgery to establish a baseline measurement of hip function and pain levels. It is then commonly repeated at regular post-operative follow-up intervals, typically at 6 months, 1 year, 2 years, and 5 years after surgery. Many national joint registries, including the UK National Joint Registry and the Swedish Hip Arthroplasty Register, mandate the collection of OHS data at specific time points for quality monitoring. The questionnaire takes approximately 5 minutes to complete and can be self-administered by patients in the waiting room or completed remotely through electronic patient-reported outcome collection systems.
What is a good Oxford Hip Score after hip replacement surgery?
A good Oxford Hip Score after total hip replacement is generally considered to be 36 or above, indicating mild or no residual hip problems. Most successful hip replacements achieve OHS scores between 38 and 46 at one year post-operatively, representing significant improvement from pre-operative baseline scores which typically range from 10 to 25. The average improvement expected after a primary total hip replacement is approximately 20 to 22 points from the pre-operative score in most published series. Scores above 42 are considered excellent outcomes, while scores below 27 at one year post-operatively may warrant further clinical investigation.
How does the Oxford Hip Score compare to the Harris Hip Score?
The Oxford Hip Score is a patient-reported outcome measure completed entirely by the patient without clinician involvement, while the Harris Hip Score is a clinician-assessed measure that requires physical examination and measurement of range of motion. The Harris Hip Score includes components for pain, function, deformity, and range of motion assessed by a healthcare professional, making it more resource-intensive to collect. Research has shown moderate to strong correlations between the OHS and Harris Hip Score, but they capture somewhat different aspects of hip function. The OHS is generally preferred in large-scale outcome studies and registries because it eliminates inter-observer variability inherent in clinician-assessed scores.
Can the Oxford Hip Score be used for conditions other than hip replacement?
While the Oxford Hip Score was specifically developed and validated for total hip replacement assessment, it has been used in studies of other hip conditions including hip resurfacing, revision hip replacement, and hip fracture treatment. However, its validity and responsiveness may be reduced in populations for which it was not originally designed, and the questions may not adequately capture the specific functional demands of younger or more active patients. For general hip osteoarthritis assessment without surgical intervention, the WOMAC or HOOS (Hip disability and Osteoarthritis Outcome Score) may be more appropriate alternatives. When using the OHS outside its validated population, results should be interpreted with appropriate caution.
References
Reviewed by Rahul Singh, Health & Wellness Specialist · Editorial policy