ACL Outcomes

SYMPTOMS

*Grade symptoms at the highest activity level at which you think you could function without significant symptoms, even if you are not actually performing activities at this level.

1. What is the highest level of activity that you can perform without significant knee pain?*

Very strenuous activities like jumping or pivoting as in basketball or soccerStrenuous activities like heavy physical work, skiing or tennisModerate activities like moderate physical work, running or joggingLight activities like walking, housework or yard workUnable to perform any of the above activities due to knee pain

2. During the past 4 weeks, or since your injury, how often have you had pain (0 = Never, 10 = Constant)?*

3. If you have pain, how severe is it (0 = No pain, 10 = Worst pain imaginable)?*

4. During the past 4 weeks, or since your injury, how stiff or swollen was your knee?*

5. What is the highest level of activity you can perform without significant swelling in your knee?*

Very strenuous activities like jumping or pivoting as in basketball or soccerStrenuous activities like heavy physical work, skiing or tennisModerate activities like moderate physical work, running or joggingLight activities like walking, housework or yard workUnable to perform any of the above activities due to knee swelling

6. During the past 4 weeks, or since your injury, did your knee lock or catch?*

YesNo

7. What is the highest level of activity you can perform without significant giving way in your knee?*

Very strenuous activities like jumping or pivoting as in basketball or soccerStrenuous activities like heavy physical work, skiing or tennisModerate activities like moderate physical work, running or joggingLight activities like walking, housework or yard workUnable to perform any of the above activities due to giving way of the knee

SPORTS ACTIVITIES

8. What is the highest level of activity you can participate in on a regular basis?*

Very strenuous activities like jumping or pivoting as in basketball or soccerStrenuous activities like heavy physical work, skiing or tennisModerate activities like moderate physical work, running or joggingLight activities like walking, housework or yard workUnable to perform any of the above activities due to knee

9. How does your knee affect your ability to:*

	Not difficult at all	Minimally difficult	Moderately difficult	Extremely difficult	Unable to do
Go up stairs
Go down stairs
Kneel on the front of your knee
Squat
Sit with your knee bent
Rise from a chair
Run straight ahead
Jump and land on your involved leg
Stop and start quickly

FUNCTION

10. How would you rate the function of your knee on a scale of 0 to 10 with 10 being normal, excellent function and 0 being the inability to perform any of your usual daily activities which may include sports?

Function prior to your knee injury:

Current function of your knee:*

IKDC-SKF Score

Please indicate how often you performed each activity in your healthiest and most active state, in the past year.*

	Less than one time in a month	One time in a month	One time in a week	2 or 3 times in a week	4 or more times in a week
Running: running while playing a sport or jogging
Cutting: changing directions while running
Deceleration: coming to a quick stop while running
Pivoting: turning your body with your foot planted while playing sport; For example: skiing, skating, kicking, throwing, hitting a ball (golf, tennis, squash), etc.

Marx Score

Consent*

Please check this box to provide your consent to use this information for the purpose of your clinical care and for research.

Research Questionnaire

ACL reconstruction or repair

Satisfaction Rating

EQ-5D-5L

IKDC-SKF

Marx Activity Scale