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Adam B. Cohen, M.D. Alexandra Voigt, NP OrthoManhattan Our Staff

Alphabetical Index ACL Surgery Revision ACL Surgery Meniscus Surgery Cartilage Restoration Total Knee Replacement Partial Knee Replacement Rotator Cuff Repair Shoulder Labral Repair Reverse Total Shoulder Replacement Total Shoulder Replacement

Alphabetical Index ACL Tears Meniscus Tears Knee Arthritis Runner's Knee Rotator Cuff Tears Shoulder Impingement Shoulder Dislocation Frozen Shoulder

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About Adam B. Cohen, M.D. Alexandra Voigt, NP OrthoManhattan Our Staff Surgical Expertise Alphabetical Index ACL Surgery Revision ACL Surgery Meniscus Surgery Cartilage Restoration Total Knee Replacement Partial Knee Replacement Rotator Cuff Repair Shoulder Labral Repair Reverse Total Shoulder Replacement Total Shoulder Replacement Practice Expertise Alphabetical Index ACL Tears Meniscus Tears Knee Arthritis Runner's Knee Rotator Cuff Tears Shoulder Impingement Shoulder Dislocation Frozen Shoulder Reviews Patient Resources New Patient Forms Pay Online Forms for Established Patients Location Location Parking

Adam B. Cohen, MD

Schedule an Office Visit 212-688-3710

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Patient Surveys

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KOOS JR - Knee injury and Osteoarthritis Outcome Score

Initials

Date

YYYY

INSTRUCTIONS: This survey asks for your view about your knee. This information will help us keep track of how you feel about your knee and how well you are able to do your usual activities. Answer every question by ticking the appropriate box, only one box for each question. If you are unsure about how to answer a question, please give the best answer you can.

Stiffness - The following question concerns the amount of joint stiffness you have experienced during the last week in your knee. Stiffness is a sensation of restriction or slowness in the ease with which you move your knee joint.

1. How severe is your knee stiffness after first wakening in the morning?

None

Mild

Moderate

Severe

Extreme

Pain. - What amount of knee pain have you experienced the last week during the following activities?

2. Twisting/pivoting on your knee

None

Mild

Moderate

Severe

Extreme

3. Straightening knee fully

None

Mild

Moderate

Severe

Extreme

4. Going up or down stairs

None

Mild

Moderate

Severe

Extreme

5. Standing upright

None

Mild

Moderate

Severe

Extreme

Function, daily living - The following questions concern your physical function. By this we mean your ability to move around and to look after yourself. For each of the following activities please indicate the degree of difficulty you have experienced in the last week due to your knee

6. Rising from sitting

None

Mild

Moderate

Severe

Extreme

7. Bending to floor/pick up an object

None

Mild

Moderate

Severe

Extreme

Thank you!

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OrthoManhattan

485 Madison Avenue, 8th Floor

New York, New York 10022

Phone: 212-688-3710

Fax: 212-688-3712

Adam B. Cohen, M.D.

485 Madison Avenue,

New York, NY, 10022,

United States

212-688-3710

Hours

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Tue 9am-5pm

Wed 9am-5pm

Thu 9am-5pm

Fri 9am-5pm

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DISCLAIMER All information contained on the adamcohenmd.com website is intended for informational and educational purposes. The information is not intended nor suited to be a replacement or substitute for professional medical treatment or for professional medical advice relative to a specific medical question or condition.