Lysholm Score For Knee Ligament Surgery

Assesses knee ligament surgery results based on activities that require knee movement.

In the text below the calculator you can find more information about the score and how it is assessed but also about the Tegner activity levels.

The Lysholm score evaluates whether after a knee ligament surgery, the patient can use their knee and perform daily activities such as walking or climbing stairs.

It checks for the existence of pain, limping or swelling and in case any of these are present, evaluates their occurrence and the discomfort caused to the patient.

The Lysholm score is not limited to post surgery care and can be used in other knee affecting conditions such as osteoarthritis.

The Lysholm score results range between 0 and 100, where 0 means severe symptoms and little to no recovery after surgery whilst 100 means no knee symptoms and full recovery after knee surgery.

Lysholm score	Surgery outcome
<65	Poor
65 – 83	Fair
84 – 94	Good
95 – 100	Excellent

Limp

I have no limp when I walk (5 points)

I have a slight or periodical limp when I walk (3 points)

I have a severe and constant limp when I walk (0 points)

Using cane or crutches

I do not use a cane or crutches (5 points)

I use a cane or crutches with some weight-bearing (2 points)

Putting weight on my hurt leg is impossible (0 points)

Locking sensation in the knee

I have no locking and no catching sensation in my knee (15 points)

I have catching sensation but no locking sensation in my knee (10 points)

My knee locks occasionally (6 points)

My knee locks frequently (2 points)

My knee feels locked at this moment (0 points)

Giving way sensation from the knee

My knee never gives way (25 points)

My knee rarely gives way, only during athletics or vigorous activity (20 points)

My knee frequently gives way during athletics or other vigorous activities. In turn I am unable to participate in these activities (15 points)

My knee occasionally gives way during daily activities (10 points)

My knee often gives way during daily activities (5 points)

My knee gives way every step I take (0 points)

Pain

I have no pain in my knee (25 points)

I have intermittent or slight pain in my knee during vigorous activities (20 points)

I have marked pain in my knee during vigorous activities (15 points)

I have marked pain in my knee during or after walking more than 1 mile (10 points)

I have marked pain in my knee during or after walking less than 1 mile (5 points)

I have constant pain in my knee (0 points)

Swelling

I have no swelling in my knee (10 points)

I have swelling in my knee only after vigorous activities (6 points)

I have swelling in my knee after ordinary activities (2 points)

I have swelling constantly in my knee (0 points)

Climbing Stairs

I have no problems climbing stairs (10 points)

I have slight problems climbing stairs (6 points)

I can climb stairs only one at a time (2 points)

Climbing stairs is impossible for me (0 points)

Squatting

I have no problems squatting (5 points)

I have slight problems squatting (4 points)

I cannot squat beyond a 90deg. Bend in my knee (1 point)

Squatting is impossible because of my knee (0 points)

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Lysholm score

As a tool evaluating surgical outcome, the knee ligament surgery score is aimed at checking how the patient performs activities such as walking, squatting or climbing stairs.

These are the 8 specific activities that are evaluated:

■ Limp: if there is any limping and if so, how severe it is and whether it is constant or not;

■ Using cane or crutches: as a support or the use of any other walking assistance;

■ Locking sensation in the knee: if such sensation is experienced and how often;

■ Giving way sensation from the knee: whether there is any instability in the knee, how often and when that occurs;

■ Pain: existence of pain and degree of discomfort caused by it;

■ Swelling: existence and persistence after different degrees of activity;

■ Climbing stairs: existence of any issues with climbing stairs;

■ Squatting: whether the action is possible and to what extent.

The Lysholm score, as introduced by Lysholm in 1982 is often included in a package of after surgery care with other physical examinations, radiographic determinations and other scales, especially in the case of young patients.

The score is not specific only to post-knee surgery and can be used in assessing mobility in other articulation involving conditions such as:

■ knee cartilage lesions;

■ knee osteoarthritis;

■ traumatic knee dislocation;

■ patellofemoral pain;

■ patellar instability;

■ meniscal tears.

Score interpretation

The 8 items in the scale have different answer choices, depending on the degree of mobility during the action or occurrence frequency of certain symptoms.

Each of these answers are weighted by a number of points ranging from 0 to 25.

The overall Lysholm score can be between 0 and 100. Scores closer to 0 indicate severe symptoms and little to no recovery after surgery whilst scores closer to 100 are indicative of very little to no knee symptoms and of the fact that the patient is likely to make a full recovery.

The following table introduces the association between the Lysholm scores and four types of surgery outcome:

Lysholm score	Surgery outcome
<65	Poor
65 – 83	Fair
84 – 94	Good
95 – 100	Excellent

Tegner activity level scale

In some clinical settings, the Lysholm knee scale is accompanied by the application of the Tegner scale. This is an activity level scale that scores mobility before and after knee surgery.

It focuses on physical activity and the patient is asked to rate how they fared before the surgery and how they consider they fare at the moment of assessment (after surgery).

The Tegner scale was introduced in 1985 and offers a prognosis of the level of activity the patient may be able to return to after their recovery is complete.

It is considered that the two instruments together offer temporal responsiveness to the knee component of the evaluation.

The 11 levels and their descriptors are introduced in the table below:

Tegner activity level	Examples of activities
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

Original source

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

Other references

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

2. Briggs K, Kocher MS, Rodkey WG, Steadman JR. 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. 2006; 88 (4): 698 -705.

Specialty: Surgery

System: Musculoskeletal

Objective: Evaluation

Type: Score

No. Of Items: 8

Year Of Study: 1982

Article By: Denise Nedea

Published On: March 16, 2017 · 11:11 AM

Last Checked: March 16, 2017

Next Review: March 10, 2023