Lysholm Score For Knee Ligament Surgery Calculator

How does this Lysholm score for knee ligament surgery calculator work?

This health tool assesses the success of knee ligament surgery based on 8 items of knee movement and symptoms. The self assessment questionnaire was published following studies in 1982.

The 8 items in the Lysholm score calculator for knee ligament surgery are the following:

■ Limp – existence of a limp while walking and if so, of what severity and whether it is periodical or constant.

■ Support – whether the subject makes use of cane, crutches or any walking assistance.

■ Locking – whether the subject experiences a sensation of locking or catching in the knee and if so, how often.

■ Instability – whether the knee gives way and if so, in what conditions and how often.

■ Pain – assesses pain existence and its degree during different activities.

■ Swelling – existence and persistence of swelling after different degrees of activity intensity.

■ Stair climbing – whether there are any issues with climbing stairs.

■ Squatting – whether the patient can squat and if so, to what extent.

Outcome scoring is an essential component of after surgery care and consists of physical examinations, radiographic determinations and the more patient focused questionnaires such as this one, that focuses mainly on younger patients.

The Lysholm score can be employed to assess other articulation related conditions such as:

■ knee cartilage lesions;

■ traumatic knee dislocation;

■ knee osteoarthritis;

■ patellofemoral pain;

■ patellar instability;

■ meniscal tears.

The main criticism received by this knee score is that it doesn’t prove adequate internal consistency in a variety of other knee conditions.

On the other hand, the scale is validated as measure of disability, meaning that it doesn’t evaluate high performance knee stability but more the patient’s perception of function. This is why it sometimes leads to higher results in patients that are less demanding.

Lysholm score interpretation

All of the 8 items in the scale consist of three or more answer choices, each of them weighted by a different number of points, from 0 to 25.

The final score ranges between 0, indicating severe symptoms and little recovery after surgery to 100, which is indicative of no knee symptoms and full recovery.

The following table presents the type of outcome in the knee ligament surgery indicated by each of the 4 ranges of scores:

Tegner activity level scale

The assessment of the Lysholm knee scale is often accompanied by the application of the Tegner score. This is an activity level scale that scores mobility before and after knee surgery in terms of the activities the subject was then and is now able to perform.

The 11 levels and their descriptors are presented below:

■ Level 10 Competitive sports - soccer, football, rugby (national elite);

■ Level 9 Competitive sports - soccer, football, rugby (lower divisions), ice hockey, wrestling, gymnastics, basketball;

■ Level 8 Competitive sports - racquetball or bandy, squash or badminton, track and field athletics (jumping, etc.), down-hill skiing;

■ Level 7 Competitive sports - tennis, running, motorcars speedway, handball; Recreational sports - soccer, football, rugby, bandy, ice hockey, basketball, squash, racquetball, running;

■ Level 6 Recreational sports - tennis and badminton, handball, racquetball, down-hill skiing, jogging at least 5 times per week;

■ Level 5 Work - heavy labor (construction, etc.) Competitive sports - cycling, cross-country skiing; Recreational sports - jogging on uneven ground at least twice weekly;

■ Level 4 Work - moderately heavy labor (e.g. truck driving, etc.);

■ Level 3 Work - light labor (nursing, etc.);

■ Level 2 Work - light labor; walking on uneven ground possible, but impossible to back pack or hike;

■ Level 1 Work - sedentary (secretarial, etc.);

■ Level 0 - Sick leave or disability pension because of knee problems.

The Tegner scale was introduced in 1985 as a mean to evaluate patient’s level of activity handicap and to prognosticate the level of activity the patient might be able to return to after surgery. The combination of the two offers the temporal responsiveness component of the evaluation.

References

1) Tegner Y, Lysolm J. (1985) Rating Systems in the Evaluation of Knee Ligament Injuries. Clinical Orthopedics and Related Research. Vol. 198: 43-49.

2) Mitsou A, Vallianatos P, Piskopakis N, Maheras S. (1990) Anterior cruciate ligament reconstruction by over-the-top repair combined with popliteus tendon plasty. J Bone Joint Surg Br; 72(3):398-404.

3) Briggs K, Kocher MS, Rodkey WG, Steadman JR. (2006) Reliability, Validity, and Responsiveness of the Lysholm Knee Score and Tegner Activity Scale for Patients with Meniscal Injury of the Knee. J Bone Joint Surg Am; 88 (4): 698 -705.

4) Lysholm J, Gillquist J. (1982) Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale. Am J Sports Med; 10-3:150-4.