Knee Quiz | Orthopedists in Lodi

There are numerous factors associated with the development of knee pain and mobility disorders. This free knee quiz will take less than 5 minutes to complete. At the end, you will receive personalized information that will help you:

Assess and identify indications of arthritis or lifestyle conditions that may lead to the development of knee pain and mobility issues.
Take action to reduce your level of pain and increase your mobility, with increased awareness of the services available through Adventist Health Lodi Memorial.

Knowing your score will enable you to take control of your health. The survey will collect your contact information to provide you with information to help address your knee pain of mobility issues. The results will also be sent to our orthopedic team.

How would you describe the pain you usually have in your knee?*
None
Very Mild
Mild
Moderate
Severe

Have you had any trouble washing and drying yourself (all over) because of your knee?*
No trouble at all
Very little trouble
Moderate trouble
Extreme difficulty
Impossible to do

Have you had any trouble getting in and out of the car or using public transport because of your knee? (With or without a stick)*
No trouble at all
Very little trouble
Moderate trouble
Extreme difficulty
Impossible to do

For how long are you able to walk before the pain in your knee becomes severe? (With or without a stick)*
No pain > 60 min
16-60 minutes
5-15 minutes
Around the house only
Not at all - severe on walking

After a meal (sat at a table), how painful has it been for you to stand up from a chair because of your knee?*
Not at all painful
Slightly painful
Moderately painful
Very painful
Unbearable

Have you been limping when walking, because of your knee?*
Rarely / never
Sometimes or just at first
Often, not just at first
Most of the time
All of the time

Could you kneel down and get up again afterwards?*
Yes, easily
With little difficulty
With moderate difficulty
With extreme difficulty
No, impossible

Are you troubled by pain in your knee at night in bed?*
Not at all
Only one or two nights
Some nights
Most nights
Every night

How much has pain from your knee interfered with your usual work? (including housework)*
Not at all
A little bit
Moderately
Greatly
Totally

Have you felt that your knee might suddenly give way or let you down?*
Rarely / never
Sometimes or just at first
Often, not at first
Most of the time
All the time

Could you do household shopping on your own?*
Yes, easily
With little difficulty
With moderate difficulty
With extreme difficulty
No, impossible

Could you walk down a flight of stairs?*
Yes, easily
With little difficulty
With moderate difficulty
With extreme difficulty
No, impossible

Patient Information

If you are a strong candidate for knee surgery, our office will contact you.
First Name*
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Last Name*
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Height (Feet) *
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Height (Inches) *
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Weight (Pounds) *
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Insurance Type *
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How did you hear about us? *
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Is this work related? *
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Have you had any previous joint replacement surgeries? *
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Birthdate*
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Email*
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Phone*
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What City do you live in?*
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What state do you live in?*
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* Required fields. By providing your details, you agree to receive communications such as annual appointment reminders, health education materials, event information, etc. from Adventist Health. For more information, you can read our legal and privacy policies in the footer below.

Congratulations!

You've completed the Knee Quiz.

Now, enter your contact information so we can send your score.

How would you describe the pain you usually have in your knee?*

Have you had any trouble washing and drying yourself (all over) because of your knee?*

Have you had any trouble getting in and out of the car or using public transport because of your knee? (With or without a stick)*

For how long are you able to walk before the pain in your knee becomes severe? (With or without a stick)*

After a meal (sat at a table), how painful has it been for you to stand up from a chair because of your knee?*

Have you been limping when walking, because of your knee?*

Could you kneel down and get up again afterwards?*

Are you troubled by pain in your knee at night in bed?*

How much has pain from your knee interfered with your usual work? (including housework)*

Have you felt that your knee might suddenly give way or let you down?*

Could you do household shopping on your own?*

Could you walk down a flight of stairs?*

Patient Information

Congratulations!