KOOS Knee Survey

INSTRUCTIONS: This survey asks for your view about your knee. This information will help us keep track of how you feel about your knee and how well you are able to perform your usual activities. Answer every question by entering the number that best fits your situation, using the scales above each section. If you are unsure about how to answer a question, please give the best answer you can.

Full Name *

Date *

Symptoms

These questions should be answered thinking of your knee symptoms during the last week.

0 - never, 1 - rarely, 2 - sometimes, 3 - often, 4 - always

S1. Do you have swelling in your knee? *

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

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

S4. Can you straighten your knee fully? *

S5. Can you bend your knee fully? *

Stiffness

The following questions concern the amount of joint stiffness you have experienced during the last week in your knee. Stiffness is a sensation of restriction or slowness in the ease with which you move your knee joint.

0 - none, 1 - mild, 2 - moderate, 3 - severe, 4 - extreme

S6. How severe is your knee joint stiffness after first waking in the morning? *

S7. How severe is you knee stiffness after sitting, laying or resting later in the day? *

Pain

What amount of knee pain have you experienced the last week during the following activities?

0 - none, 1 - mild, 2 - moderate, 3 - severe, 4 - extreme

P1. How often do you experience knee pain? *

P2. Twisting/pivoting on your knee *

P3. Straightening knee fully? *

P4. Bending knee fully *

P5. Walking on flat surface *

P6. Going up or down stairs *

P7. At night while in bed *

P8. Sitting or lying *

P9. Standing upright *

Function, daily living

The following questions concern your physical function. By this we mean your ability to move around and to look after yourself. For each of the following activities please indicate the degree of difficulty you have experienced in the last week due to your knee.

A1. Descending stairs *

A2. Ascending stairs *

A3. Rising from sitting *

A4. Standing *

A5. Bending to floor/pick up mild object *

A6. Walking on flat surface *

A7. Getting in/out car *

A8 Going shopping *

A9. Putting on socks/stockings *

A10. Rising from bed *

A11. Taking off socks/stockings *

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

A13. Getting in/out of bath *

A14. Sitting *

A15. Getting on/off toilet *

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

A17. light domestic duties (cooking, dusting, etc) *

Function, sports and recreational activities

The following questions concern your physical function when being active on a higher level. The questions should be answered thinking of what degree of difficulty you have experienced during the last week due to your knee.

SP1. Squatting *