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NEW ZEALAND JOINT REPLACEMENT PRIORITY SCORES
Ring the score which best applies and add all ringed numbers together for
total score
Name:................................................................................................
Date:.................................
PAIN
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| Degree (while on maximal medical
therapy) |
Score |
Occurence |
Score |
| None |
0 |
With first steps only |
0 |
| Mild (slight or occasional, no alteration to
activity or work) |
4 |
Only after 30 minutes walk |
4 |
| Mild-to-moderate (moderate or frequent but
no change to activities) |
6 |
With all walking but mainly in the day |
10 |
| Moderate (active but has had to alter
activities) |
9 |
Significant, regular pain at night |
20 |
| Moderate-severe (fairly severe pain,
substantial limitation of activities) |
14 |
|
|
| Severe (major pain, serious limitation of activities) |
20 |
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FUNCTION
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|
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| Time walked |
Score |
Other functional limitations*
|
Score |
| Unlimited |
0 |
None |
0 |
| 31-60 minutes |
2 |
Mild |
2 |
| 11-30 minutes |
4 |
Moderate |
4 |
| 2-10 minutes |
6 |
Severe |
10 |
| <2 minutes or indoors only |
8 |
*(putting on shoes, managing stairs, getting out of a
chair, sexual activity, hobbies, need for walking aids) |
| Unable to walk |
10 |
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MOVEMENT AND DEFORMITY
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|
|
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| Pain on examination (active and
passive range of motion) |
Score |
Other abnormal orthopaedic
findings* |
Score |
| None |
0 |
None |
0 |
| Mild |
2 |
Mild |
2 |
| Moderate |
5 |
Moderate |
5 |
| Severe |
10 |
Severe |
10 |
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*(reduced range of motion, deformity,
limp, instability, changes on x-ray) |
OTHER FACTORS
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|
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| Multiple joint disease |
Score |
Ability to work, care for others, live
independently, relating to affected joint |
Score |
| No |
0 |
Not threatened or difficult |
0 |
| Yes (each other joint mild-moderately
affected) |
4 |
Not threatened but more difficult |
4 |
| Yes (each other joint severely affected) |
10 |
Threatened, but not immediately |
6 |
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|
Immediately threatened |
10 |
Total score:............................. Assessed
by:.......................................................................................
Hadorn DC, Holmes AC. The New Zealand priority criteria project. Part 1:
Overview. BMJ 1997;314:131-134.
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