Lysholm Knee Scoring System

Closeup over the shoulder view of an early 60's senior gentleman having some knee pain. He's at doctor's office having medical examination by a male doctor. The doctor is touching the sensitive area and trying to determine the cause of pain.

Lysholm Knee Score

The first version of the Lysholm scale was published in 1982 in The American Journal of Sports Medicine and consisted of eight (8) questions that focused on the categories of limping, support, locking, instability, pain, swelling, stair climbing and squatting. A revised version of Lysholm was introduced in 1985 and added one (1) item regarding knee locking, while removing other items relating to pain/swelling on giving-way, the objective measurement of thigh atrophy and the reference to walking, running and jumping.

Following these modifications, the Lysholm scoring scale reached the standard required to become a patient reported outcome measure (PROM) and as with all PRO measures, the modified questionnaire enhanced patient perspectives of their illness.

The Lysholm scale consists of eight items with each question response being assigned an arbitrary score on an increasing scale. The total score is the sum of each response to the eight questions and may range from 0-100 where higher scores indicate a better outcome with fewer symptoms or disability. Scores are also categorized as excellent (95-100), good (84-94), fair (65-83) and poor (<65).

Strengths

The Lysholm Knee Scoring Scale has an extended use beyond evaluating outcomes of knee ligament surgery. It can also be used for meniscal tears, knee cartilage lesions, osteochondritis dissecans, traumatic knee dislocation, patellar instability, patellofemoral pain and knee osteoarthritis. A study carried out by Briggs et al. showed the Lysholm questionnaire to have acceptable test-retest reliability, floor and ceiling effects, criterion validity, construct validity and responsiveness to change.

A great strength of the Lysholm scale is that it’s relatively quick and easy for patients to complete, does not have a complicated scoring methodology, and is a free tool.

Considerations

The Lysholm scale appears to have inadequate internal consistency in patients with a variety of knee conditions and although test–retest reliability is adequate for use in groups with knee injuries, studies have found that it is less than adequate for patients with mixed knee pathologies. Additionally, the Lysholm scale was originally developed as a clinician-administered measure rather than a patient self-reported measure.While the measure generally uses simple language there are some terms such as locking and catching that patients may need further clarification on.

Licensing and Cost

Free. The Lysholm Knee Scoring System does not require a license.

Sources | Reliability, validity and responsiveness of the Lysholm knee scale for various chondral disorders of the knee | What knee scoring system? S. Tilley and N. Thomas | Measures of Knee Function

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