Please answer the following multiple-choice questions. Your answers should regard to the past 4 weeks.

1. How would you describe the pain you usually have in your knee?
__ None
__ Very mild
__ Mild
__ Moderate
__ Severe

2. 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

3. 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

4. For how long are you able to walk before the pain in your knee becomes severe? (With or without a stick)
__ No pain > 60 minutes
__ 16 – 60 minutes
__ 5 – 15 minutes
__ Around the house only
__ Not at all- severe on walking

5. 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

6. 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

7. Could you kneel down and get up again afterwards?

__ Yes, easily
__ With little difficulty
__ With moderate difficulty
__ With extreme difficulty
__ No, impossible

8. 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

9. How much has pain from your knee interfered with your usual work? (Including housework)
__ Not at all
__ A little bit
__ Moderately
__ Greatly
__ Totally

10. 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

11. Could you do household shopping on your own?
__ Yes, easily
__ With little difficulty
__ With moderate difficulty
__ With extreme difficulty
__ No, impossible

12. Could you walk down a flight of stairs? __ Yes, easily
__ With little difficulty
__ With moderate difficulty
__ With extreme difficulty
__ No, impossible

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