Knee injury and Osteoarthritis Outcome Score (KOOS) Survey

Knee injury and Osteoarthritis Outcome Score (KOOS) Survey
Name*

First NameSurname
Date*

DayMonthYear
Date
Affected Knee:

Left kneeRight knee
This survey asks for your opinion about your knee and helps us understand how well you are able to complete your usual activities. Answer each question by ticking the appropriate box (only one box for each question). If you are uncertain about how to answer a question, please give the best answer you can.
Symptoms

Answer these questions thinking of your knee symptoms during the last week.
S1. Do you have swelling in your knee?*

NeverRarelySometimesOftenAlways
S2. Do you feel grinding, hear clicking, or any other type of noise when your knee moves?*

NeverRarelySometimesOftenAlways
S3. Does your knee catch or hang up when moving?*

NeverRarelySometimesOftenAlways
S4. Can you straighten your knee fully?*

AlwaysOftenSometimesRarelyNever
S5. Can you bend your knee fully?*

AlwaysOftenSometimesRarelyNever
Stiffness is a sensation of restriction or slowness in the ease with which you move your knee joint.
S6. How severe is your knee joint stiffness after first wakening in the morning?*

NoneMildModerateSevereExtreme
S7. How severe is your knee joint stiffness after sitting, lying, or resting later in the day?*

NoneMildModerateSevereExtreme
P1. How often do you experience knee pain?*

NeverMonthlyWeeklyDailyAlways
What amount of knee pain have you experienced the last week during the following activities?
P2. Twisting/pivoting on your knee*

NoneMildModerateSevereExtreme
P3. Straightening knee fully*

NoneMildModerateSevereExtreme
P4. Bending knee fully*

NoneMildModerateSevereExtreme
P5. Walking on flat surface*

NoneMildModerateSevereExtreme
P6. Going up or down stairs*

NoneMildModerateSevereExtreme
P7. At night while in bed*

NoneMildModerateSevereExtreme
P8. Sitting or lying*

NoneMildModerateSevereExtreme
P9. Standing upright*

NoneMildModerateSevereExtreme
Function, daily living

This section describes your ability to move around and to look after yourself. For each of the following activites, please indicate the degree of difficulty you have experienced in the last week due to your knee.
A1. Descending stairs*

NoneMildModerateSevereExtreme
A2. Ascending stairs*

NoneMildModerateSevereExtreme
A3. Rising from sitting*

NoneMildModerateSevereExtreme
A4. Standing*

NoneMildModerateSevereExtreme
A5. Bending to the floor/pick up an object*

NoneMildModerateSevereExtreme
A6. Walking on a flat surface*

NoneMildModerateSevereExtreme
A7. Getting in/out of car*

NoneMildModerateSevereExtreme
A8. Going shopping*

NoneMildModerateSevereExtreme
A9. Putting on socks/stockings*

NoneMildModerateSevereExtreme
A10. Rising from bed*

NoneMildModerateSevereExtreme
A11. Taking off socks/stockings*

NoneMildModerateSevereExtreme
A12. Lying in bed (turning over, maintaining hip position)*

NoneMildModerateSevereExtreme
A13. Getting in/out of bath*

NoneMildModerateSevereExtreme
A14. Sitting*

NoneMildModerateSevereExtreme
A15. Getting on/off toilet*

NoneMildModerateSevereExtreme
A16. Heavy domestic duties (moving heavy boxes, scrubbing floors, etc)*

NoneMildModerateSevereExtreme
A17. Light domestic duties (cooking, dusting, etc)*

NoneMildModerateSevereExtreme
Function, sports and recreational activities

This section describes your ability to be active on a higher level. For each of the following activities, please indicate the degree of difficulty you have experienced in the last week due to your knee.
SP1. Squatting*

NoneMildModerateSevereExtreme
SP2. Running*

NoneMildModerateSevereExtreme
SP3. Jumping*

NoneMildModerateSevereExtreme
SP4. Twisting/pivoting on loaded knee*

NoneMildModerateSevereExtreme
SP5. Kneeling*

NoneMildModerateSevereExtreme
Quality of Life
Q1. How often are you aware of your knee problem?*

NeverMonthlyWeeklyDailyConstantly
Q2. Have you modified your life style to avoid activities potentially damaging to your knee?*

Not at allMildlyModeratelySeverelyTotally
Q3. How much are you troubled with lack of confidence in your knee?*

Not at allMildlyModeratelySeverelyTotally
Q4. In general, how much difficulty do you have with your knee?*

NoneMildModerateSevereExtreme
Understanding results

Each subscale will get a score of 0 to 100, with 0 indicating extreme symptoms and 100 indicating no symptoms.
Symptoms sub section
Pain sub section
Function, daily living sub section
Function, sports and recreational activities
Quality of life
Should be Empty: