The Hospital for Special Surgery in New York City used a disability sheet for the functional evaluation of patients following total knee arthroplasty. This could be followed over time to monitor the patient's recovery from surgery and response to interventions.
Parameters:
(1) pain (maximum 30 points)
(1a) pain on walking (maximum 15 points)
(1b) pain at rest (maximum 15 points)
(2) function (maximum 22 points)
(2a) walking and standing (maximum 12 points)
(2b) climbing stairs (maximum 5 points)
(2c) transfer activity (maximum 5 points)
(3) range of motion (maximum 18 points)
(4) muscle strength (maximum 10 points)
(5) flexure deformity (maximum points 10 points)
(6) instability (maximum 10 points)
|
Parameter |
Finding |
Points |
|
pain on walking |
none |
15 |
|
|
mild |
10 |
|
|
moderate |
5 |
|
|
severe |
0 |
|
pain at rest |
none |
15 |
|
|
mild |
10 |
|
|
moderate |
5 |
|
|
severe |
0 |
|
walking and standing |
unlimited |
12 |
|
|
can walk 5 to 10 blocks; can stand more than 30 minutes |
10 |
|
|
can walk 1 to 5 blocks; can stand up to 30 minutes |
8 |
|
|
can walk less than 1 block |
4 |
|
|
unable to walk |
0 |
|
climbing stairs |
capable |
5 |
|
|
requires support |
2 |
|
|
unable to perform |
0 |
|
transfer activity |
capable |
5 |
|
|
requires support |
2 |
|
|
unable to perform |
0 |
|
range of motion |
1 point for each 8° of arch |
max 18 |
|
muscle strength |
good; cannot break quadriceps power |
10 |
|
|
good; can break quadriceps power |
8 |
|
|
fair; moves though arc of motion |
4 |
|
|
poor; cannot move through arc of motion |
0 |
|
flexure deformity |
none |
10 |
|
|
a few degrees (0 to 4 degrees) |
8 |
|
|
5 to 10 degrees |
5 |
|
|
11 degrees or more |
0 |
|
instability |
none |
10 |
|
|
mild (0 to 5 degrees) |
8 |
|
|
moderate (6 to 15 degrees) |
5 |
|
|
severe (16 degrees or more) |
0 |
from Figure 1, page 77
Subtraction points:
(1) supports
(2) extension lag
(3) valgus deformity
(4) varus deformity
|
Parameter |
Finding |
Points |
|
supports |
none |
0 |
|
|
1 cane |
1 |
|
|
1 crutch |
2 |
|
|
2 crutches |
3 |
|
extension lag |
none |
0 |
|
|
5 degrees |
2 |
|
|
10 degrees |
3 |
|
|
15 degrees or more |
5 |
|
valgus deformity |
none |
0 |
|
|
5 degrees |
1 |
|
varus deformity |
none |
0 |
|
|
5 degrees |
1 |
from remarks to Figure 1, page 77
where:
• For the range of motion I rounded the value (range divided by 8).
Specialty: Surgery, orthopedic
