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5256
§ 4.71a Schedule of ratings—musculoskeletal system.

Knee stiffness or immobility (ankylosis)

Severe knee stiffness in which the joint is fixed or has very limited movement.

What the rating means

VA rates ankylosis of the knee under diagnostic code 5256. Ankylosis means the knee is permanently stiff and fixed at a certain angle, with no meaningful movement remaining. The rating depends entirely on what angle your knee is locked at, because some positions are more disabling than others.

A 30% rating applies when the knee is fixed in full extension or in slight flexion anywhere from 0° to 10°, which is considered a favorable angle for walking. A 40% rating applies when the knee is fixed between 10° and 20° of flexion. A 50% rating applies when the knee is fixed between 20° and 45° of flexion. A 60% rating applies when the knee is fixed at 45° of flexion or more, which is considered extremely unfavorable because it forces a severely bent position that makes standing and walking very difficult.

The higher the degree of flexion at which the knee is locked, the higher the rating, because greater fixed flexion causes more functional impairment.

Evidence that helps

The key evidence for this condition is documentation showing that your knee is permanently fixed and at what angle it is locked. A VA examination or private orthopedic evaluation that measures and records the exact angle of ankylosis is the most direct form of evidence. Goniometer readings taken during a range-of-motion exam are particularly useful because the rating criteria turn on precise degree measurements.

Imaging such as X-rays can help confirm structural changes consistent with ankylosis. Surgical records, treatment notes, and prior examination reports that consistently show a fixed angle over time support the finding that the stiffness is permanent rather than temporary.

Statements from you or people who know you describing how the fixed knee affects your ability to stand, walk, climb stairs, or perform work duties can help show the real-world impact of the angle at which your knee is locked. These statements are most useful when they connect specific activities to the position of your knee, since each rating level corresponds to a different degree of flexion.

Secondary conditions

Conditions that are often caused or made worse by this one. If you have any of these, they may be claimable as secondary service connection.