The Reliability of HSS Knee Rating System

ABSTRACT

PURPOSE: The rating system of Hospital for Special Surgery(HSS knee score) has been used to evaluate the clinical results of knee arthroplasty, but it may happen to interobserver bias. The purpose of this study is to detect how much and what it could make the bias. MATERIALS AND METHODS: From Sept 1998 to May 1999, HSS score of 115 cases of knee which were planned for total knee arthroplasty were caku4ted by three observers(knee joint specialist A, orthopedic specialist B, orthapedic resident C) and compared the result with Wilcoxon sided ranks test for the eval-uation of statistical differences and the Kappa statistics for the test of statistical reliability. RESULTS: The mean HSS knee scores of observer A, B, C were 64.8 points, 61.] points and 59.4 points respectively. The average difference were average 4.8 point in total score and it was statistically significant(p<0.05) and The items of pain(walking, at rest) and function(walking distance) showed least agreements(k<0.20). CONCLUSIONS: More objective and quantitative criteria is needed in the items of pain on walking and at rest and distance of walking for accurate evaluation of results using HSS system.