Additional questions:
Have you been active in sports prior to your ailment? __ Yes __ No
Have you been active in sports in the last 4 weeks? __ Yes __ No
Have you relied on pain medication during the past 4 weeks? __ Yes __ No
VAS Pain score: Please use the scale below to tell us how intense your pain is. Place an X by the number that best describes the intensity of your pain. This scale relates to the average pain that you had during the past 4 weeks.
0 - No pain to 10 - The most intense pain sensation imaginable.
__0 __1 __2 __3 __4 __5 __6 __7 __8 __9
How bad should the Oxford Hip or Knee score be to justify total joint replacement?
Every day, Surgeons make a clinical judgement about the severity of symptoms
and whether total joint replacement is justified. This depends on many other
factors over and above a patient- completed score, including age, work and intercurrent
disease. This is part of the art of being a clinician.
Nevertheless NHS doctors are being asked to ration joint replacements on the
basis of Oxford Hip and Knee scores. How bad should the scores be to justify
joint replacement?
One way of assessing this is to look at reported series where patients have come
to hip and knee replacements and see what the recorded pre-operative Oxford
Hip and Knee Scores were.
The calculation of the score has recently changed from a 60-12 bad-good
scoring, to a 0-48 bad-good scoring. The interpretation below of the published
scores takes this into consideration.
Orthopaedics Scores uses the new 0-48 system, where 0 is the worst and 48 the
best. The first answer equals 1 in value, the second equals 2, the third equals 3, the fourth equals 4, the fifth equals 5. Add up your answers and subtract them from 60 for your score
Conclusion: There is therefore reasonable scientific evidence that; Anyone
with an Oxford Hip or Knee score below 20 should be referred for joint
replacement.
Finally, post-operative grading for Hip replacement was proposed by
Kalairajah etal (http://www.ncbi.nlm.nih.gov/pubmed/16376260) and is adopted
in orthopaedicscores.com as follows:
Excellent 42-48, Good 34-41, Fair 27-33, Poor 0-26