PROMs

Oxford Knee Score (OKS) Clinical Workflow

Oxford Knee Score flow

Introduction

The Oxford Knee Score (OKS) is a 12-item patient-reported PRO specifically designed and developed to assess function and pain after total knee replacement (TKR) surgery (arthroplasty). It is short, reproducible, valid and sensitive to clinically important changes[1].

The Oxford Knee Score flow contains the Oxford Knee Score (OKS) questionnaire and associated calculation. After form submission, the Oxford Knee Score calculation is executed automatically. It's easy to extend this flow with conditional logic based on the interpretation of the Oxford Knee Score calculation.

Oxford Knee Score (OKS) questionnaire

Questions and Scoring

When the OKS was originally developed, it was designed to be as simple as possible in order to promote use. The original scoring system was a 1-5 where one represented the best outcome[2]. However, clinicians found this confusing in practice and adaptations began to appear so the original authors developed a new scoring system from 0-4 where four is the best outcome and total scores range from 0 (worst outcome) to 48 (best outcome)[2].

Awell only supports the 0 to 4 scoring system.

Questions:

  1. How would you describe the pain you usually have from your knee?
  2. Have you had any trouble with washing and drying yourself (all over) because of your knee?
  3. Have you had any trouble getting in and out of a car or using public transport because of your knee? (whichever you tend to use)
  4. For how long have you been able to walk before the pain from your knee becomes severe (with or without a stick)
  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?
  6. Have you been limping when walking, because of your knee?
  7. Could you kneel down and get up again afterwards?
  8. Have you been troubled by pain from your knee in bed at night?
  9. How much has pain from your knee interfered with your usual work (including housework)?
  10. Have you felt that your knee might suddenly “give way” or let you down?
  11. Could you do the household shopping on your own?
  12. Could you walk down a flight of stairs?

Click here to open the English version of the OKS in PDF

Interpretation

Total scores ranges from 0 (worst outcome) to 48 (best outcome).

Score range
Interpretation
[0,19] May indicate severe knee arthritis. It is highly likely that you may well require some form of surgical intervention, contact your family physician for a consult with an Orthopaedic Surgeon.
[20,29] May indicate moderate to severe knee arthritis. See your family physician for an assessment and x-ray. Consider a consult with an Orthopaedic Surgeon.
[30,39] May indicate mild to moderate knee arthritis. Consider seeing your family physician for an assessment and possible x-ray. You may benefit from non-surgical treatment, such as exercise, weight loss, and /or anti-inflammatory medication
[40,48] May indicate satisfactory joint function. May not require any formal treatment.

References

[1] Dawson J, Fitzpatrick R, Murray D, Carr A. Questionnaire on the perceptions of patients about total knee replacement surgery. J. Bone Joint Surg 1998; 80-B:63-69. Accessed 15 January 2020.\
[2] Oxford University Innovation. The Oxford Knee Score (OKS). 2016. Accessed online from https://innovation.ox.ac.uk/outcome-measures/oxford-knee-score-oks/ on 15 January 2020.

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