Knee Functionality and Pain Survey

How do I know if I need surgery?

Chronic pain can often creep from manageable to a situation that requires surgery without you recognising the change. Are you a candidate for a total knee replacement?

The following survey consists of twelve questions, which will help assess the severity of your knee pain and the functionality of your knee. This self-assessment tool can be utilised to monitor the degree of pain and indicate possible treatment options available. You will be required to provide information so that we can send you your results. 

If your knee is swollen, infected or causing you severe pain, organise to see a doctor right away. 

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1. How severe would you describe your typical knee pain?*
2. How often do you feel like your knee might suddenly give way?*
3. Does your knee pain cause you to limp when walking?*
4. How difficult is it to perform your daily activities (work, housework, etc.) because of your knee pain?*
5. How long can you walk before your knee pain starts to appear, either with or without a walking stick?*
6. How difficult/painful is it in your knee to stand up after sitting for some time?*
7. How difficult is it to get in and out of the car or use public transport, either with or without a walking stick, because of your knee pain?*
8. How difficult is it to go shopping on your own?*
9. How difficult is it to walk up or down a flight of stairs?*
10. How difficult is it to stand up after kneeling?*
11. How difficult is it to wash and dry yourself because of your knee pain?*
12. How severe is your pain when laying in bed at night?*

Patient Details

Your results will be emailed and you will be contacted by the Ortho Precision team if we feel you are a strong candidate for our knee pain treatment services.

Have you previously had a joint replacement?
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