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A joint is formed by the meeting of the ends of two or more ....    more
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KNEE JOINT REPLACEMENT IN INDIA MEDICAL QUESTIONNAIRE 

We hope that while sending us your treatment enquiry you have answered following as patient's case histories?

1. Write to us your name and  contact details.

2. What are your main complains?

3. Your current diagnosis or condition. If known, then, send by email or by UPS / DHL / FedEx courier original reports or copy of recent clinical observations / diagnosis / medical report translated into English.

4. Do you have results from tests or investigations at other hospitals that you can share with us?

5. How would you describe the pain you usually have from your knee (scoring categories; None / Very mild / Mild / Moderate / Severe)?

6. Have you had any trouble with washing and drying yourself (all over) because of your knee (scoring categories; No trouble at all / Very limited trouble / Moderate trouble / Extreme difficulty / Impossible to do)?

7. 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] (scoring categories;No trouble at all / Very limited trouble / Moderate trouble / Extreme difficulty / Impossible to do)?

8. For how long have you been able to walk before the pain from you rknee becames severe [with or without a stick] (scoring categories; No pain/>30 minutes / 16 to 20 minutes / 5 to 15 minutes / around the house only / Not at all - severe on walking)?

9. After a meal (sat at a table), how painful has it been for you to stand up from a chair because of your knee (scoring categories;Not at all painful / Slightly painful / Moderatley painful / Very painful / Unbearable)?

10. Have you been limping when walking, because of your knee (scoring categories; Rarely or never / Sometimes or just at first / Often, not just at first / Most of the time / All of the time)?

11. Could you knee down and get up again afterwards (scoring categories;Yes, easily / With little difficulty / With moderate difficulty / With extreme difficulty / No, impossible)?

12. Have you been troubled by pain from your knee in bed at night (scoring categories;No nights / Only 1 or 2 nights / Some nights / Most nights / Every nights)?

13. How much has pain from your knee interfered with your usual work [including housework?] (scoring categories;Not at all / A little bit / Moderately / Greatly / Totally)?

14. Have you felt that your knee might suddenly "give way" or let you down (scoring categories;Rarely or never / Sometimes or just at first / Often,not just at first / Most of the time / All of the time)?

15. Could you do the household shopping on your own (scoring categories;Yes, easily / With little difficulty / With moderate difficulty / With extreme difficulty / No, impossible)?

16. Could you walk down a flight of stairs (scoring categories;Yes, easily / With little difficulty / With moderate difficulty / With extreme difficulty / No, impossible)?

17. Are you diabetic?

18. Do you have any cardiac history?

19. What is your age?

20. Has the patient got any difficulty in passing urine?
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