The KOOS asks 42 questions about one knee over the past week. It gives five separate scores, each from 0 to 100, for pain, symptoms, daily activities, sport and recreation, and knee-related quality of life: 100 means no knee problems. See how to score each subscale, what a score and a change in score mean, and record the result with the free template. The official form comes from its source.
KOOS result template
FreeKOOS RESULT Date: [Date] Patient: [Name or ID, age] Version: [Full 42-item KOOS, KOOS-12, or KOOS JR; official form and language] How it was completed: [Paper in clinic, online before the visit, or tablet in the waiting room] KNEE Side scored: [Left or right; the knee the patient was asked to answer about] Diagnosis: [Osteoarthritis, ligament or meniscus injury, cartilage lesion, or other] Surgery: [Procedure and date, or none] Visit: [Pre-treatment baseline, or weeks or months since surgery or injury] SUBSCALE SCORES Pain: [0 to 100; items answered out of 9] Symptoms: [0 to 100; items answered out of 7] Activities of daily living: [0 to 100; items answered out of 17] Sport and recreation: [0 to 100; items answered out of 5, or not scored and why] Knee-related quality of life: [0 to 100; items answered out of 4] Short-form score: [KOOS-12 summary or KOOS JR interval score, if that version was used] CHANGE FROM BASELINE Baseline scores: [Date and all five subscale scores] Change per subscale: [Points gained or lost on each; 8 to 10 points or more is a meaningful change] Previous result: [Date and scores at the last review] INTERPRETATION Profile: [Which subscales are near normal and which lag behind] What the patient reports: [The activities and worries behind the lowest subscale, in their words] Exam and imaging: [Range of motion, effusion, quadriceps strength, stability, X-ray] Impression: [What the scores add to the diagnosis and the expected course] PLAN Treatment: [Exercise therapy, weight management, injection, bracing, surgery, or rehab phase] Work, sport, and activity: [What the patient can do now, and the tests needed before more] Repeat KOOS: [Date or interval, with the same version] Clinician: [Name, credentials]
Use it for
The patient fills in the official form alone, about one knee, thinking about the past week. It takes about 10 minutes, and it can be done at home before the visit.
Avoid: Reading the questions over the phone or asking them as an interview. The KOOS is built to be completed by the patient.
Each item scores 0 to 4. For each subscale, take the mean of the answered items, multiply by 25, and subtract from 100.
Avoid: Adding all 42 answers into one number. There is no valid KOOS total, and a sum hides where the problem is.
Read the five scores together, as a shape: higher is better on every subscale, and the low ones show where the knee limits life.
Avoid: Using a descriptive level to decide treatment. The levels put a number into words; they aren’t cut-offs.
Give it before treatment, then at set points afterwards, such as 6 weeks, 3 months, 6 months, and 1 year after surgery.
Avoid: Calling a 4-point rise on one subscale an improvement. It is within measurement error.
The full KOOS suits most knee problems at any age from the teens up. The short forms trade detail for speed.
Avoid: Comparing a KOOS JR score with a full KOOS subscale from an earlier visit. They are different scores.
Each one follows the recording template. Use them to judge how much to write.
Orthopedic surgery clinic, 6-month review after a left total knee replacement
63-year-old retired letter carrier who walks his dog twice a day and keeps a vegetable garden. Left medial knee osteoarthritis, bone on bone on X-ray, after a year of exercise therapy, weight loss, and injections. Left total knee replacement on May 7. Full KOOS on a tablet in the waiting room, all 42 items answered, about the left knee.
Pain 86.1, mild or none. Symptoms 78.6, mild or none. ADL 88.2, mild or none. Sport/Rec 45.0, marked. QOL 68.8, moderate.
Before surgery, on March 18: Pain 33.3, Symptoms 39.3, ADL 42.6, Sport/Rec 10.0, QOL 18.8. Gains of 52.8, 39.3, 45.6, 35.0, and 50.0 points: every subscale far past the 8 to 10 point minimal important change, and past the 13 to 21 points of measurement error in osteoarthritis. Quality of life gained the most, as it often does after a knee replacement.
Pain and daily activities are now close to what men his age without knee problems report. Sport/Rec lags: he can’t kneel in the garden yet and squats only halfway. Walks 40 minutes with the dog without a stick. Wound healed. Knee moves from full extension to 118° of flexion, no effusion, stable to varus and valgus stress, quadriceps 4+/5. X-ray: components well fixed and aligned. Impression: an excellent result; the remaining limit is kneeling, which is common after a knee replacement and often eases over the first year.
Discharged from formal physical therapy to a home program: quadriceps and step-up work 3 times a week. Kneeling practice on a thick cushion, building from 1 to 5 minutes, and a kneeling pad or low stool for gardening. No restriction on walking. Review at 1 year with an X-ray and the full KOOS. Come back sooner for new pain, swelling, warmth, or fever.
Sports medicine clinic, return-to-sport review 9 months after a right ACL reconstruction
24-year-old warehouse associate who plays point guard in a city basketball league twice a week. Right ACL rupture on a landing in January; hamstring tendon graft and a small partial medial meniscectomy on February 9. Wants to play the league season starting in January. Full KOOS on paper in clinic, all 42 items answered, about the right knee.
Pain 91.7, mild or none. Symptoms 85.7, mild or none. ADL 97.1, mild or none. Sport/Rec 55.0, moderate. QOL 43.8, marked.
Before surgery, on February 2: Pain 61.1, Symptoms 57.1, ADL 76.5, Sport/Rec 15.0, QOL 25.0. At 6 months, Sport/Rec 45.0 and QOL 37.5. Since 6 months, Sport/Rec is up 10 points but QOL only 6.3, under the minimal important change. Both remain well below the acceptable levels reported after ACL reconstruction in one study, about 75 for Sport/Rec and 62.5 for QOL.
Daily life is back to normal; sport and confidence are not. He says the knee feels fine on straight-line running but he hesitates on hard cuts and one-leg landings and doesn’t trust it yet. No effusion, full extension, flexion 140°, firm end point on Lachman testing, pivot shift negative. Quadriceps strength 78% of the left side on dynamometry; single-leg hop for distance 84%, triple hop 82%. Impression: stable graft, not yet ready for pivoting sport; the quadriceps deficit and low trust in the knee match the low Sport/Rec and QOL scores.
No league games yet; shooting and non-contact drills are fine. Rehab twice a week for 8 weeks: heavy quadriceps strengthening, landing and plyometric work, then cutting drills building to non-contact team practice. Explained that going back with a strength deficit raises the chance of a second ACL injury. Retest strength and hops and repeat the full KOOS in 8 weeks; full play when quadriceps strength and hop tests reach 90% of the other side and he feels ready.
A KOOS total isn’t valid, and the developer advises against one. A patient with Pain 90 and Sport/Rec 20 has a clear problem that an average of 55 would blur.
On the KOOS, 100 means no problems; on the WOMAC, higher is worse. Write “improved” only when a KOOS subscale rises.
With fewer than half the items answered, such as 1 of 4 for QOL, no score can be calculated for that subscale. Report the others and note the gap.
Sport/Rec often stays lower after a replacement, and older adults without knee problems don’t score 100 either. Set goals from the patient’s activities and age, not the top of the scale.
A KOOS JR score of 70 and a full KOOS Pain score of 70 aren’t the same thing. Keep one version from baseline to discharge.
The score doesn’t show the side. When both knees hurt, tell the patient which knee to answer about and write it down, or later scores can’t be compared.
Vero Scribe records the KOOS result in your template from the visit, with the patient’s consent, or from your dictation: the five subscale scores, the change from baseline, what you found on exam, and the plan. You review and edit every line, then copy it into your record. Vero works in 60+ languages.
Score each of the five subscales on its own. Each item scores 0 to 4; take the mean of the answered items in the subscale, multiply by 25, and subtract the result from 100. For example, a mean of 1.5 gives 100 − 37.5 = 62.5. At least half the items in a subscale must be answered. There is no total score.
Higher is better on every subscale, and 100 means no knee problems. The developer sets no official cut-offs. As a guide, this page reads 0 to 25 as severe problems, above 25 to 50 as marked, above 50 to 75 as moderate, and above 75 as mild or none. Adults without knee problems usually score high, but scores fall with age, so compare a patient with their own baseline and with people their age.
No. The five subscales measure different things and are reported separately; the developer says a total score is never recommended. Trials sometimes use a KOOS4, the average of the Pain, Symptoms, Sport/Rec, and QOL scores, as one primary outcome, but they report all five subscales too.
The developer suggests a minimal important change of 8 to 10 points per subscale, while noting that it depends on the patient group, treatment, and follow-up time. Measurement error is larger in knee osteoarthritis, about 13 to 21 points by subscale, so a change in one patient with arthritis should be bigger before it’s called real.
The full KOOS has 42 items and five subscales. The KOOS-12 has 12 of those items, giving Pain, Function, and Quality of life scores and a summary score, each 0 to 100. The KOOS JR has 7 items, built at Hospital for Special Surgery for knee replacement; its raw total is converted with a table to one score from 0 to 100, where 100 is perfect knee health. The short forms suit busy clinics and joint replacement programs; the full KOOS gives more detail, especially for active patients.
The KOOS was built from the WOMAC and contains all its items, so WOMAC scores can be calculated from a completed KOOS. It adds the Sport/Rec and Quality of life subscales, which pick up problems in younger and more active patients that the WOMAC misses. The direction differs too: on the KOOS, higher is better; on the WOMAC, higher is worse.
The patient completes it, on paper or online, in about 10 minutes, so any member of the team can hand it out: surgeons, physical therapists, nurses, or clinic staff. It has been used in people aged 13 to 79, and a separate KOOS-Child version exists for younger children. A clinician goes over the result with the patient.
Permission is always needed, and it’s requested through Mapi Research Trust’s ePROVIDE platform, linked from the official KOOS site. Academic users, funded or not, use it free; clinics, hospitals, and commercial users pay a fee that depends on the type of organization. Get the official form and translations that way. The recording template on this page is free to copy or download.
Patient-reported measures of symptoms and function, scored as T-scores with 50 as the average: short forms, CATs, and the PROMIS-29.
Six basic self-care activities rated independent or dependent, scored 0 to 6, for function and care needs in older adults.
Eight independent living tasks, from shopping to finances, each scored 0 or 1: a total from 0, dependent, to 8, independent.
Eleven questions on arm, shoulder, and hand function over the past week, scored 0 to 100: the higher, the more disability.
Twenty everyday activities rated for difficulty: lower limb function scored 0 to 80, higher is better, and 9 points is a real change.
Where the baseline KOOS goes, with the knee exam, goals, and plan of care.
Subscale scores against baseline, goal status, and the next phase of rehab.
For the knee replacement or ligament reconstruction that the KOOS follows up.
Pre-op visits, post-op reviews, and knee clinic notes.
Vero records scores, findings, and plans in the templates you choose, so you review instead of type.
No credit card required. 10 free actions every month.