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Protocol - Knee Injury and Osteoarthritis

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Description:

A self-administered questionnaire consisting 42 Likert-style items in five subscales: Pain, Other Symptoms, Function in Daily Living (ADL), Function in Sport and Recreation (Sport/Rec), and Knee-Related Quality of Life (QOL). Appropriate for ages 13-79.

Scoring notes: The previous week is the time period considered when answering the questions. Standardized answer options are given (five Likert boxes), and each question is assigned a score from 0 to 4. A normalized score (100 indicating no symptoms and 0 indicating extreme symptoms) is calculated for each subscale (scoring instructions are available in a separate document named [alink[4_KOOS_Scoring_2012.pdf|KOOS Scoring 2012.pdf]])

Specific Instructions:

At least 50% of items within each subscale need to be answered in order to calculate a score. This questionnaire can also be used to derive Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores.

Protocol:

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 ticking the appropriate box, only one box for each question. If you are unsure about how to answer a question, please give the best answer you can.

Symptoms

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

S1. Do you have swelling in your knee?

[ ] Never

[ ] Rarely

[ ] Sometimes

[ ] Often

[ ] Always

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

[ ] Never

[ ] Rarely

[ ] Sometimes

[ ] Often

[ ] Always

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

[ ] Never

[ ] Rarely

[ ] Sometimes

[ ] Often

[ ] Always

S4. Can you straighten your knee fully?

[ ] Always

[ ] Often

[ ] Sometimes

[ ] Rarely

[ ] Never

S5. Can you bend your knee fully?

[ ] Always

[ ] Often

[ ] Sometimes

[ ] Rarely

[ ] Never

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.

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

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

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

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

Pain

P1. How often do you experience knee pain?

[ ] Never

[ ] Monthly

[ ] Weekly

[ ] Daily

[ ] Always

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

P2. Twisting/pivoting on your knee

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

P3. Straightening knee fully

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

P4. Bending knee fully

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

P5. Walking on flat surface

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

P6. Going up or down stairs

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

P7. At night while in bed

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

P8. Sitting or lying

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

P9. Standing upright

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

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

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

A2. Ascending stairs

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

For each of the following activities please indicate the degree of difficulty you have experienced in the last week due to your knee.

A3. Rising from sitting

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

A4. Standing

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

A5. Bending to floor/pick up an object

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

A6. Walking on flat surface

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

A7. Getting in/out of car

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

A8. Going shopping

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

A9. Putting on socks/stockings

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

A10. Rising from bed

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

A11. Taking off socks/stockings

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

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

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

A13. Getting in/out of bath

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

A14. Sitting

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

A15. Getting on/off toilet

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

For each of the following activities please indicate the degree of difficulty you have experienced in the last week due to your knee.

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

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

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

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

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

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

SP2. Running

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

SP3. Jumping

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

SP4. Twisting/pivoting on your injured knee

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

SP5. Kneeling

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

Quality of Life

Q1. How often are you aware of your knee problem?

[ ] Never

[ ] Monthly

[ ] Weekly

[ ] Daily

[ ] Constantly

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

to your knee?

[ ] Not at all

[ ] Mildly

[ ] Moderately

[ ] Severely

[ ] Totally

Q3. How much are you troubled with lack of confidence in your knee?

[ ] Not at all

[ ] Mildly

[ ] Moderately

[ ] Severely

[ ] Extremely

Q4. In general, how much difficulty do you have with your knee?

[ ] None

[ ] Mild

[ ] Moderate

[ ] Severe

[ ] Extreme

Thank you very much for completing all the questions in this questionnaire.

Protocol Name from Source:

Knee injury and Osteoarthritis Outcome Score (KOOS)

Availability:

Publicly available

Personnel and Training Required

None

Equipment Needs
None
Requirements
Requirement CategoryRequired
Major equipment No
Specialized training No
Specialized requirements for biospecimen collection No
Average time of greater than 15 minutes in an unaffected individual No
Mode of Administration

Self-administered questionnaire

Life Stage:

Adolescent, Adult, Senior

Participants:

Patients 13-79 years of age

Selection Rationale

The KOOS instrument demonstrates good test-retest reliability, content validity and internal consistency with adult and older adult populations.

Language

English

Standards
StandardNameIDSource
Common Data Elements (CDE) Knee Joint Knee Injury and Osteoarthritis Outcome Score Questionnaire Assessment Score 6356766 CDE Browser
Derived Variables

None

Process and Review

The Expert Review Panel has yet to review this measure.

Source

Roos, E.M., Roos, P.H., Lohmander, L.S., Ekdahl, C., Beynnon, B.D. (1998) Knee injury and Osteoarthritis Outcome Score (KOOS). Development of a self-administered outcome measure. J Orthop Sports Phys Ther, 78(2):88-96

Knee injury and Osteoarthritis Outcome Score (KOOS), English version LK1.0

General References

Ageberg, E., Forssblad, M., Herbertsson, P., & Roos, E. M. (2010). Sex differences in patient-reported outcomes after anterior cruciate ligament reconstruction: Data from the Swedish Knee Ligament Register. American Journal of Sports Medicine, 38, 1334-1342.

Alviar, M. J., Olver, J., Brand, C., Hale, T., & Khan, F. (2011). Do patient-reported outcome measures used in assessing outcomes in rehabilitation after hip and knee arthroplasty capture issues relevant to patients? Results of a systematic review and ICF linking process. Journal of Rehabilitation Medicine: Official Journal of the UEMS European Board of Physical and Rehabilitation Medicine, 43, 374-381.

Bellamy, N., Buchanan, W. W., Goldsmith, C. H., Campbell, J., & Stitt, L. W. (1988). Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. Journal of Rheumatology, 15, 1833-1840.

Collins, N. J., Prinsen, C.A., Christensen, R., Bartels, E.M., Terwee, C.B., Roos, E.M. (2016). Knee Injury and Osteoarthritis Outcome Score (KOOS): systematic review and meta-analysis of measurement properties. Osteoarthritis Cartilage, 24(8): 1317-1329.

Collins, N. J., Misra, D., Felson, D. T., Crossley, K. M., & Roos, E. M. (2011). Measures of knee function: International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, Knee Injury and Osteoarthritis Outcome Score (KOOS), Knee Injury and Osteoarthritis Outcome Score Physical Function Short Form (KOOS-PS), Knee Outcome Survey Activities of Daily Living Scale (KOS-ADL), Lysholm Knee Scoring Scale, Oxford Knee Score (OKS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Activity Rating Scale (ARS), and Tegner Activity Score (TAS). Arthritis Care and Research;63(Suppl. 11), S208-S228.

Collins, N. J., & Roos, E. M. (2012). Patient-reported outcomes for total hip and knee arthroplasty: commonly used instruments and attributes of a "good" measure. Clinics in Geriatric Medicine, 28, 367-394.

Frobell, R. B., Svensson, E., Gothrick, M., & Roos, E. M. (2008). Self-reported activity level and knee function in amateur football players: The influence of age, gender, history of knee injury and level of competition. Knee Surgery, Sports Traumatology, Arthroscopy, 16, 713-719.

Garratt, A. M., Brealey, S., & Gillespie, W. J. (2004). Patient-assessed health instruments for the knee: A structured review. Rheumatology (Oxford), 43, 1414-1423.

Gudbergsen, H., Bartels, E. M., Krusager, P., Waehrens, E. E., Christensen, R., Danneskiold-Samsoe, B., & Bliddal, H. (2011). Test-retest of computerized health status questionnaires frequently used in the monitoring of knee osteoarthritis: a randomized crossover trial. BMC Musculoskeletal Disorders, 12, 190.

Nilsdotter, A. K., Toksvig-Larsen, S., & Roos, E. M. (2009). A 5 year prospective study of patient-relevant outcomes after total knee replacement. Osteoarthritis Cartilage, 17, 601-606.

Ostenberg, A., Roos, E., Ekdahl, C., & Roos, H. (2000). Physical capacity in female soccer players-does age make a difference? Advances in Physiotherapy, 2, 39-48.

Paradowski, P. T., Bergman, S., Sunden-Lundius, A., Lohmander, L. S., & Roos, E. M. (2006). Knee complaints vary with age and gender in the adult population. Population-based reference data for the Knee injury and Osteoarthritis Outcome Score (KOOS). BMC Musculoskeletal Disorders, 7, 38.

Rodriguez-Merchan, E. C. (2012). Knee instruments and rating scales designed to measure outcomes. Journal of Orthopaedics andTraumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology, 13, 1-6.

Roos, E., Engelhart, L., Ranstam, J., Anderson, A., Irrgang, J., Marx, R., . . . Davis, A. M. (2011). ICRS Recommendation Document: Patient-reported outcome instruments for use in patients with articular cartilage defects. Cartilage, 2, 122-136.

Roos, E. M., & Lohmander, L. S. (2003). Knee injury and Osteoarthritis Outcome Score (KOOS): From joint injury to osteoarthritis. Health and Quality of Life Outcomes, 1, 64.

Roos, E. M., Klassbo, M., & Lohmander, L. S. (1999). WOMAC osteoarthritis index. Reliability, validity, and responsiveness in patients with arthroscopically assessed osteoarthritis. Western Ontario and McMaster Universities. Scandinavian Journal of Rheumatolology, 28, 210-215.

Roos, E. M., Roos, H. P., & Lohmander, L. S. (1999). WOMAC Osteoarthritis Index-Additional dimensions for use in subjects with post-traumatic osteoarthritis of the knee. Western Ontario and McMaster Universities. Osteoarthritis Cartilage, 7, 216-221.

 Wright, R. W. (2009). Knee injury outcomes measures. Journal of the American Academy of Orthopaedic Surgeons, 17, 31-39

Protocol ID:

250401

Variables:
Export Variables
Variable NameVariable IDVariable DescriptionVersiondbGaP Mapping
PX250401_Knee_Injury_Osteoarthritis_Bend_Fully PX250401010500 Can you bend your knee fully? N/A
PX250401_Knee_Injury_Osteoarthritis_Catch_Hang_Moving PX250401010300 Does your knee catch or hang up when moving? N/A
PX250401_Knee_Injury_Osteoarthritis_Function_Ascend_Stairs PX250401030200 For each of the following activities please indicate the degree of difficulty you have experienced in the last week due to your knee. Ascending stairs N/A
PX250401_Knee_Injury_Osteoarthritis_Function_Bathtub PX250401031300 For each of the following activities please indicate the degree of difficulty you have experienced in the last week due to your knee. Getting in/out of bath N/A
PX250401_Knee_Injury_Osteoarthritis_Function_Bending_Floor PX250401030500 For each of the following activities please indicate the degree of difficulty you have experienced in the last week due to your knee. Bending to floor/pick up an object N/A
PX250401_Knee_Injury_Osteoarthritis_Function_Descend_Stairs PX250401030100 For each of the following activities please indicate the degree of difficulty you have experienced in the last week due to your knee. Descending stairs N/A
PX250401_Knee_Injury_Osteoarthritis_Function_Enter_Exit_Car PX250401030700 For each of the following activities please indicate the degree of difficulty you have experienced in the last week due to your knee. Getting in/out of car N/A
PX250401_Knee_Injury_Osteoarthritis_Function_Heavy_Domestic_Duties PX250401031600 For each of the following activities please indicate the degree of difficulty you have experienced in the last week due to your knee. Heavy domestic duties (moving heavy boxes, scrubbing floors, etc.) N/A
PX250401_Knee_Injury_Osteoarthritis_Function_Jumping PX250401040300 The questions should be answered thinking of what degree of difficulty you have experienced during the last week due to your knee. Jumping N/A
PX250401_Knee_Injury_Osteoarthritis_Function_Kneeling PX250401040500 The questions should be answered thinking of what degree of difficulty you have experienced during the last week due to your knee. Kneeling N/A
PX250401_Knee_Injury_Osteoarthritis_Function_Light_Domestic_Duties PX250401031700 For each of the following activities please indicate the degree of difficulty you have experienced in the last week due to your knee. Light domestic duties (cooking, dusting, etc.) N/A
PX250401_Knee_Injury_Osteoarthritis_Function_Lying PX250401031200 For each of the following activities please indicate the degree of difficulty you have experienced in the last week due to your knee. Lying in bed (turning over, maintaining knee position) N/A
PX250401_Knee_Injury_Osteoarthritis_Function_Remove_Stocks_Stockings PX250401031100 For each of the following activities please indicate the degree of difficulty you have experienced in the last week due to your knee. Taking off socks/stockings N/A
PX250401_Knee_Injury_Osteoarthritis_Function_Rising_Bed PX250401031000 For each of the following activities please indicate the degree of difficulty you have experienced in the last week due to your knee. Rising from bed N/A
PX250401_Knee_Injury_Osteoarthritis_Function_Rising_Sitting PX250401030300 For each of the following activities please indicate the degree of difficulty you have experienced in the last week due to your knee. Rising from sitting N/A
PX250401_Knee_Injury_Osteoarthritis_Function_Running PX250401040200 The questions should be answered thinking of what degree of difficulty you have experienced during the last week due to your knee. Running N/A
PX250401_Knee_Injury_Osteoarthritis_Function_Shopping PX250401030800 For each of the following activities please indicate the degree of difficulty you have experienced in the last week due to your knee. Going shopping N/A
PX250401_Knee_Injury_Osteoarthritis_Function_Sitting PX250401031400 For each of the following activities please indicate the degree of difficulty you have experienced in the last week due to your knee. Sitting N/A
PX250401_Knee_Injury_Osteoarthritis_Function_Socks_Stockings PX250401030900 For each of the following activities please indicate the degree of difficulty you have experienced in the last week due to your knee. Putting on socks/stockings N/A
PX250401_Knee_Injury_Osteoarthritis_Function_Squatting PX250401040100 The questions should be answered thinking of what degree of difficulty you have experienced during the last week due to your knee. Squatting N/A
PX250401_Knee_Injury_Osteoarthritis_Function_Standing PX250401030400 For each of the following activities please indicate the degree of difficulty you have experienced in the last week due to your knee. Standing N/A
PX250401_Knee_Injury_Osteoarthritis_Function_Toilet PX250401031500 For each of the following activities please indicate the degree of difficulty you have experienced in the last week due to your knee. Getting on/off toilet N/A
PX250401_Knee_Injury_Osteoarthritis_Function_Twisting_Pivoting PX250401040400 The questions should be answered thinking of what degree of difficulty you have experienced during the last week due to your knee. Twisting/pivoting on your injured knee N/A
PX250401_Knee_Injury_Osteoarthritis_Function_Walking_Flat_Surface PX250401030600 For each of the following activities please indicate the degree of difficulty you have experienced in the last week due to your knee. Walking on flat surface N/A
PX250401_Knee_Injury_Osteoarthritis_Grinding_Clicking_Noise PX250401010200 Do you feel grinding, hear clicking or any other type of noise when your knee moves? N/A
PX250401_Knee_Injury_Osteoarthritis_Pain_Bend_Fully PX250401020400 What amount of knee pain have you experienced the last week during the following activities? Bending knee fully N/A
PX250401_Knee_Injury_Osteoarthritis_Pain_Frequency PX250401020100 How often do you experience knee pain? N/A
PX250401_Knee_Injury_Osteoarthritis_Pain_Night_Bed PX250401020700 What amount of knee pain have you experienced the last week during the following activities? At night while in bed N/A
PX250401_Knee_Injury_Osteoarthritis_Pain_Sitting_Lying PX250401020800 What amount of knee pain have you experienced the last week during the following activities? Sitting or lying N/A
PX250401_Knee_Injury_Osteoarthritis_Pain_Stairs PX250401020600 What amount of knee pain have you experienced the last week during the following activities? Going up or down stairs N/A
PX250401_Knee_Injury_Osteoarthritis_Pain_Standing_Upright PX250401020900 What amount of knee pain have you experienced the last week during the following activities? Standing upright N/A
PX250401_Knee_Injury_Osteoarthritis_Pain_Straighten_Fully PX250401020300 What amount of knee pain have you experienced the last week during the following activities? Straightening knee fully N/A
PX250401_Knee_Injury_Osteoarthritis_Pain_Twisting_Pivoting PX250401020200 What amount of knee pain have you experienced the last week during the following activities? Twisting/pivoting on your knee N/A
PX250401_Knee_Injury_Osteoarthritis_Pain_Walking_Flat_Surface PX250401020500 What amount of knee pain have you experienced the last week during the following activities? Walking on flat surface N/A
PX250401_Knee_Injury_Osteoarthritis_Quality_Life_Awareness PX250401050100 How often are you aware of your knee problem? N/A
PX250401_Knee_Injury_Osteoarthritis_Quality_Life_Change PX250401050200 Have you modified your life style to avoid potentially damaging activities to your knee? N/A
PX250401_Knee_Injury_Osteoarthritis_Quality_Life_Confidence PX250401050300 How much are you troubled with lack of confidence in your knee? N/A
PX250401_Knee_Injury_Osteoarthritis_Quality_Life_Difficulty PX250401050400 In general, how much difficulty do you have with your knee? N/A
PX250401_Knee_Injury_Osteoarthritis_Stiffness_Morning PX250401010600 How severe is your knee joint stiffness after first wakening in the morning? N/A
PX250401_Knee_Injury_Osteoarthritis_Stiffness_Sitting_Lying_Resting PX250401010700 How severe is your knee stiffness after sitting, lying or resting later in the day? N/A
PX250401_Knee_Injury_Osteoarthritis_Straighten_Fully PX250401010400 Can you straighten your knee fully? N/A
PX250401_Knee_Injury_Osteoarthritis_Swelling PX250401010100 Do you have swelling in your knee? N/A
Geriatrics
Measure Name:

Knee Injury and Osteoarthritis

Release Date:

N/A

Definition

A self-administered questionnaire to assess the patient's opinion about their knee and associated problems. Intended to be used for knee injury that can result in post-traumatic osteoarthritis (OA) as well as knee OA.

Purpose

Chronic inflammation of the knee or post-traumatic osteoarthritis (OA) can cause physical and emotional distress, result in limitations on functional ability and daily living activities, and can negatively impact an individual's quality of life.

Keywords

Swelling, stiffness, joint, pain, standing, recreation, limitations, disability, injury, Knee injury and Osteoarthritis Outcome Score (KOOS), anterior cruciate ligament, ACL, lateral collateral ligament, LCL, cartilage, meniscus, osteoarthritis, physical trauma, sports injury, gerontology, aging