London Hip and Knee Surgeon

1. How would you describe the pain you usually have in your Hip?

None Very mild Mild Moderate Severe

2. Have you been troubled by pain from your hip in bed at night?

No Nights Only 1 or 2 nights Some nights Most nights Every night

3. Have you had any sudden, severe pain (shooting, stabbing, or spasms) from your affected hip?

No days Only 1 or 2 days Some days Most days Every day

4. Have you been limping when walking because of your hip?

Rarely/never Sometimes or just at first Often, not just at first ost of the time All of the time

5. For how long have you been able to walk before the pain in your hip becomes severe (with or without a walking aid)?

No pain for 30 minutes or more 16 to 30 minutes 5 to 15 minutes Around the house only Not at all

6. Have you been able to climb a flight of stairs?

Yes, easily With little difficulty With moderate difficulty With extreme difficulty No, impossible

7. Have you been able to put on a pair of socks, stockings or tights?

Yes, easily With little difficulty With moderate difficulty With extreme difficulty No, impossible

8. After a meal (sat at a table), how painful has it been for you to stand up from a chair because of your hip?

Not at all painful Slightly painful Moderately painful Very painful Unbearable

9. Have you had any trouble getting in and out of a car or using public transportation because of your hip?

No trouble at all Very little trouble Moderate trouble Extreme difficulty Impossible to do

10. Have you had any trouble with washing and drying yourself (all over) because of your hip?

No trouble at all Very little trouble Moderate trouble Extreme difficulty Impossible to do

11. Could you do household shopping on your own?

Yes, easily With little difficulty With moderate difficulty With extreme difficulty No, impossible

12. How much has pain from your hip interfered with your usual work, including housework?

Not at all A little bit Moderately Greatly Totally

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Oxford Hip Score