Validation of the Hughston Clinic subjective knee questionnaire using gait analysis

Subjective questionnaires, completed by the patient, are often used to document the status of a disabled knee. The purpose of this study was to validate the Hughston Clinic subjective knee questionnaire by describing how knee kinematics and kinetics correlated to subjective knee scores after knee injury and surgery.

Five groups were studied: patients 2 (N = 37), 6 (N = 37), and 24 (N = 8) wk after ACL reconstruction (ACLR); patients with a chronic PCL deficiency (N = 9); and uninjured controls (N = 8). A three-dimensional motion analysis system and force platform were used to measure flexion angles and knee moments during level walking and stair climbing.

Hughston Clinic questionnaire scores were significantly correlated to mechanical descriptors measured during stair ascent and descent in the 2- and 6-wk ACLR groups (P < 0.05). The Hughston Clinic questionnaire score was correlated to several kinematic variables in the ACL reconstructed knee at 24 wk postoperative, e.g., knee flexion during walking. In the PCL deficient group, the Hughston Clinic questionnaire score was correlated with several kinetic measures, e.g., the peak moment (knee extensors). The Hughston Clinic questionnaire score was not correlated to knee mechanics in the control group.

The Hughston Clinic questionnaire score has been shown to be valid in this study as it reflects some mechanical descriptors during activities of daily living in the first 6 wk post ACL reconstruction. The questionnaire also provides information on gait modifications by people coping with knee injuries.