The Research Sub-Committee of the British Orthopaedic Association developed a standard evaluation chart for assessing patients before and after reconstructive surgery to the knee. The score can be monitored over time to determine the effect of interventions on the patient's functional ability.
Parameters related to the affected knee:
(1) assessment of the patient (attitude, disability due knee disorder)
(2) pain
(3) ability to walk
(4) walking aid
(5) gait
(6) flexion deformity
(7) maximum flexion
(8) extension lag (additional to flexion contracture if present)
(9) valgus angle
(10) varus angle
(11) ability to get out of chair
(12) ability to climb stairs
In addition, the assessment chart includes evaluation of the other major joints of the lower extremities. This is described in the next section.
|
Parameter |
Finding |
Points |
|---|---|---|
|
patient attitude |
enthusiastic |
4 |
|
|
satisfied |
3 |
|
|
non-committal |
2 |
|
|
disappointed |
1 |
|
disability due to the affected knee |
entirely |
4 |
|
|
mainly |
3 |
|
|
partially |
2 |
|
|
scarcely at all |
1 |
|
pain |
none |
4 |
|
|
mild pain, not interfering with activities or sleep |
3 |
|
|
moderate pain, either reducing activities or disturbing sleep |
2 |
|
|
severe pain |
1 |
|
ability to walk |
> 1 kilometer (unlimited), or > 60 minutes |
5 |
|
|
up to 1 kilometer, or 31-60 minutes |
4 |
|
|
51-100 meters outdoors, or 11-30 minutes |
3 |
|
|
up to 50 meters, or 5-10 minutes |
2 |
|
|
indoors only |
1 |
|
|
unable |
0 |
|
walking aid |
none |
4 |
|
|
stick outside |
3 |
|
|
stick always |
2 |
|
|
two sticks or crutches, or the use of frame |
1 |
|
|
unable to walk |
0 |
|
gait |
normal free swing |
4 |
|
|
slight limitation in swing |
3 |
|
|
minimal movement |
2 |
|
|
stiff knee |
1 |
|
flexion deformity |
0 degrees |
5 |
|
|
1 - 10 degrees (< 10) |
4 |
|
|
11 – 20 degrees |
3 |
|
|
21 – 30 degrees |
2 |
|
|
> 30 degrees |
1 |
|
maximum flexion |
> 100 degrees |
4 |
|
|
81 – 100 degrees |
3 |
|
|
61 – 80 degrees |
2 |
|
|
<= 60 degrees (< 60 degrees) |
1 |
|
extension lag (in addition to flexion contracture, if present) |
0 degrees |
4 |
|
|
1 – 9 degrees (< 10) |
3 |
|
|
10 – 19 degrees (< 20) |
2 |
|
|
>= 20 degrees |
1 |
|
valgus angle (when the tibia is stressed laterally) |
0 to 10 degrees |
4 |
|
|
11 – 19 degrees (< 20) |
3 |
|
|
20 – 29 degrees (< 30) |
2 |
|
|
>= 30 degrees (> 30) |
1 |
|
varus angle (when tibia is stressed medially) |
0 degrees |
5 |
|
|
1 to 9 degrees |
4 |
|
|
10 – 19 degrees (< 20) |
3 |
|
|
20 – 29 degrees (< 30) |
2 |
|
|
>= 30 degrees (> 30) |
1 |
|
ability to get out of chair |
with ease |
4 |
|
|
with difficulty |
3 |
|
|
only by using arms |
2 |
|
|
unable |
1 |
|
ability to climb stairs |
normal |
4 |
|
|
one step at a time |
3 |
|
|
only with a bannister, stick or both |
2 |
|
|
only by a bizarre method |
1 |
|
|
unable |
1 |
where:
• For ability to walk, the original table has "up to 50 metres" assigned 3 points, while "50-100 metres" is assigned 2 points. The value for 50 meters is uncertain, so this was adjusted to prevent overlap.
• In the ability to walk, the times were "30 – 60 minutes" and 10 – 30 minutes". I adjusted these so they would not overlap.
• For flexion deformity, "< 10" is used as "<= 10". For maximum flexion "< 60" is used as "<= 60". For extension lag, the points when 20 degrees is could be 2 or 1. For valgus and varus angle, the points when 30 degrees could be 2 or 1.
• I am not sure what a "bizarre method" for climbing stairs involves, but I imagine it may include sitting on the stair facing out and pushing up.
total score =
= SUM(points for all 12 parameters)
Interpretation:
• minimum score: 11
• maximum score: 55
• The higher the score, the greater the functional ability.
percent of normal functional ability =
= ((total) – 11) / 44 * 100%
Specialty: Surgery, orthopedic
