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Knee Quiz

Clinician's name (or ref)




Date of completion

Patient's name (or ref)

 
Please answer the following 12 multiple choice questions.
During the past 4 weeks......
1. How would you describe the pain you usually have in your knee?   7. Could you kneel down and get up again afterwards?
none   yes, easily
very mild   with little difficulty
mild   with moderate difficulty
moderate   with extreme difficulty
severe   no, impossible
 
2. Have you had any trouble washing and drying yourself (all over) because of your knee?   8. Are you troubled by pain in your knee at night in bed?
no trouble at all   not at all
very little trouble   only one or two nights
moderate trouble   some nights
extreme difficulty    most nights
impossible to do   every night
 
3. Have you had any trouble getting in and out of the car or using public transport because of your knee? (with or without a stick)   9. How much has pain from your knee interfered with your usual work? (including housework)
no trouble at all   not at all
very little trouble   a little bit
moderate trouble   moderately
extreme difficulty   greatly 
impossible to do   totally
 
4. For how long are you able to walk before the pain in your knee becomes s eve re? (with or without a stick)   10. Have you felt that your knee might suddenly "give away" or let you down?
no pain > 60 min   rarely / never
16 - 60 minutes   sometimes or just at first 
5 - 15 minutes   often, not at first
around the house only   most of the time
not at all - severe on walking   all the time
 
5. After a meal (sat at a table), how painful has it been for you to stand up from a chair because of your knee?   11. Could you do household shopping on your own?
not at all painful   yes, easily
slightly painful   with little difficulty
moderately pain   with moderate difficulty
very painful   with extreme difficulty
unbearable   no, impossible
 
6. Have you been limping when walking, because of your knee?   12. Could you walk down a flight of stairs?
rarely / never   yes, easily
sometimes or just at first   with little difficulty
often, not just at first   with moderate difficulty
most of the time   with extreme difficulty
all of the time   no, impossible

Knee Quiz Score Is:


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Interpreting The Score
score 0 to 19 may indicate severe knee arthritis. it is highly likely that you may well require some form of surgical intervention, contact your family physician for a consult with an orthopaedic surgeon.
score 20 to 29

may indicate moderate to severe knee arthritis. see your family physician for an assessment and x-ray. consider a consult with an orthopaedic surgeon.

score 30 to 39

may indicate mild to moderate knee arthritis. consider seeing your family physician for an assessment and possible x-ray. you may benefit from non-surgical treatment, such as exercise, weight loss, and /or anti-inflammatory medication

score 40 to 48

may indicate satisfactory joint function. may not require any formal treatment.

Reference for Score:  Dawson J, Fitzpatrick R, Carr A, Murray D. Questionnaire on the perceptions of patients about total hip replacement. J Bone Joint Surg Br. 1996 Mar;78(2):185-90. Link