Recognizing the need for standardized, reliable and valid instruments to measure the outcomes of musculoskeletal care, the American Academy of Orthopaedic Surgeons (AAOS), in conjunction with a number of orthopaedic specialty societies, created a series of outcomes instruments, or measuring tools. In 1999, the AAOS, along with the Council of Musculoskeletal Societies (COMSS) and the Council of Spine Societies, undertook a normative data study that has provided these standardized scores for the general population.

"Normative" condition scores for the general population serve as a reference group and allow doctors to assess whether individuals meet established criteria for a specific disorder. These "normative" or standard scores represent an invaluable tool for orthopaedic surgeons that will be used in conjunction with the physical examination process to determine diagnosis, pain tolerance, and surgical necessity. Data for the study was collected using a mail survey sent to a representative number of the general public.

Based on a 37% response rate, general population normative scores were calculated by which to compare patients' scores in clinical and research settings. The collection of this data was a necessary step in the standardization process for any condition or disorder. The AAOS study serves as a national orthopaedic database, providing healthcare practitioners with tools to better recognize, identify and treat musculoskeletal conditions in conjunction with traditional diagnosis procedures.

The AAOS developed outcomes instruments tools to study lumbar and cervical spine, upper limb, lower limb, hip, knee, foot, ankle, and sports knee. Pediatric tools are also available. These instruments, in the form of questionnaires, along with the normative data standardized scores, are available to download from the AAOS website and can be used by physicians both domestically and internationally. Several foreign language translations of some instruments are also available.

The 25,500-member American Academy of Orthopaedic Surgeons (, is a not-for-profit organization that provides education programs for orthopaedic surgeons, allied health professionals and the public.