Knee Joint Surgery - Leeds, Yorkshire

Knee Symptom Form Examination Form Knee Arthoscopy Examination Technique

The knee symptom form and Examination form are to help General practitioners, Sports Physicians and Physiotherapists refer patients with adequate information. The information is also designed to help Orthopaedic trainees/ residents learn a systematic examination technique. This page is not for patients to self refer themselves to my clinic.

Please Contact my Secretary
Ms Christine Kirkham on
07784476138

All the content are provided for information only and though of high quality do NOT constitute professional medical advice.
Please consult a specialist for advice on your condition.

*Name:
*Age:
*Email:
Knee:	Left Right
History

Symptom Start Date:
Injury Description:
Felt pop at Injury:
Pain:	Medial Lateral Anterior Posterior
Walking Distance:
Night Pain:
Pain on stair climbing or walking down inclines:
Swelling:
Giving Way:
When and how many times:
Locking:
Patella Dislocations:	Dislocations Subluxations None
How Often:
Treatment:	Medication Physiotherapy None
Previous Surgery:
Past Medication:
Occupation/Leisure Activities/Tegner Score: