Oxford Knee Score

If you have been advised by the practice 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.

Oxford Knee Score

Oxford Knee Score

If you are human, leave this field blank.

Please only complete this form if you have been specifically requested to do so. Any submitted forms that have not been requested by a Medical Professional will be voided.

Full Name: *

Date of Birth: *

Please use this date format: DD/MM/YYYY.

Phone Number:

Email Address: *

Any responses we send will go to this 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 away or let you down? *

Rarely/Never

Sometimes or just at first

Often, not at first

Most of the time

All 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