X

Oxford Knee Score

If you have been advised by the surgery to submit an Oxford Knee Score please use this form.

Score Grading

  • 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.
Full Name:


Date of Birth:


Phone Number:


Email Address:


During the past 4 weeks...

How would you describe the pain you usually have in your knee?
None
Very mild
Mild
Moderate
Severe

Have you had any trouble washing and drying yourself (all over) because of your knee?
No trouble at all
Very little trouble
Moderate trouble
Extreme difficulty
Impossible to do

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

For how long are you able to walk before the pain in your knee becomes severe? (With or without a stick)
No pain > 60 min
16 - 60 minutes
5 - 15 minutes
Around the house only
Not at all - severe on walking

After a meal (sat at a table), how painful has it been for you to stand up from a chair because of your knee?
Not at all painful
Slightly painful
Moderately painful
Very painful
Unbearable

Have you been limping when walking, because of your knee?
Rarely / Never
Sometimes or just at first
Often, not just at first
Most of the time
All of the time

Could you kneel down and get up again afterwards?
Yes, easily
With little difficulty
With moderate difficulty
With extreme difficulty
No, impossible

Are you troubled by pain in your knee at night in bed?
Not at all
Only one or two nights
Some nights
Most nights
Every night

How much has pain from your knee interfered with your usual work? (including housework)
Not at all
A little bit
Moderately
Greatly
Totally

Have you felt that your knee might suddenly give way or let you down?
Rarely / Never
Sometimes or just at first
Often, not just at first
Most of the time
All of the time

Could you do household shopping on your own?
Yes, easily
With little difficulty
With moderate difficulty
With extreme difficulty
No, impossible

Could you walk down a flight of stairs?
Yes, easily
With little difficulty
With moderate difficulty
With extreme difficulty
No, impossible

I confirm that the information provided is accurate to the best of my knowledge.

I confirm that I am currently within the UK at the time of sending my enquiry.