Assessing the results of hip replacement. A comparison of five different rating systems.

One hundred hips in patients who had had primary uncemented replacements were followed up for one or two years, and assessed by five different methods. All produced different results. The Hospital for Special Surgery rating produced the most optimistic assessment and the Merle d'Aubigné rating the most pessimistic. The functional class of the patients, as defined by Charnley in 1979, significantly affected the ratings, and these should clearly be included in all rating systems. Moreover, if systems are to be compared, they should all use descriptive words, such as limp or pain, in precisely the same way.