Lysholm Knee Score: domains, weights and post-ACL application
Complete Lysholm guide — 8 weighted domains, interpretation bands, MCID and combined use with the Tegner Activity Scale.
What is the Lysholm Knee Score?
The Lysholm Knee Score was developed by Lysholm and Gillquist (1982) specifically for functional assessment of the knee in ligamentous injuries. It is one of the oldest instruments still widely used, particularly in the context of ACL injuries and chronic knee instability.
Unlike the IKDC and KOOS, the Lysholm uses different weights for each domain, reflecting the relative impact of each symptom on global knee function. Instability and pain — the two heaviest domains (25 pts each) — account for 50% of the total score.
The Lysholm is frequently applied together with the Tegner Activity Scale: the Lysholm quantifies current function; the Tegner documents the activity level achieved.
The 8 domains and their weights
| Domain | Max weight | What it assesses |
|---|---|---|
| Limp | 5 pts | Gait alteration |
| Support | 5 pts | Need for brace or crutch |
| Locking | 15 pts | Joint locking episodes |
| Instability | 25 pts | Giving way and instability sensation |
| Pain | 25 pts | Frequency and intensity of pain |
| Swelling | 10 pts | Joint oedema |
| Stairs | 10 pts | Climbing and descending stairs |
| Squatting | 5 pts | Ability to squat |
Total score = direct sum of 8 domains = 0 to 100 pts. Higher = better function.
Calculate the LYSHOLM for free
Apply the questionnaire online and get the score with exportable PDF.
Interpretation bands
| Score | Classification | Clinical interpretation |
|---|---|---|
| ≥ 95 | Excellent | No significant functional limitation |
| 84–94 | Good | Mild limitation in demanding activities |
| 65–83 | Fair | Moderate limitation, sports activities affected |
| < 65 | Poor | Significant limitation, evaluation and intervention needed |
MCID and post-ACL application
The MCID of the Lysholm is approximately 8–10 points in ACL injury populations (Briggs et al., 2009). The scale is more sensitive to changes during the functional recovery phase than in patients with stabilised injuries.
| Post-ACL timepoint | Expected score |
|---|---|
| Pre-operative | 55–70 pts |
| 6 months post-op | 70–85 pts |
| 12 months post-op | 80–90 pts |
| Clinical discharge (excellent) | ≥ 95 pts |
References
- 1. 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.
- 2. Tegner Y, Lysholm J. “Rating systems in the evaluation of knee ligament injuries.” Clin Orthop Relat Res, 1985;(198):43–9.
- 3. Briggs KK, Lysholm J, Tegner Y, et al. “The reliability, validity, and responsiveness of the Lysholm score and Tegner activity scale for anterior cruciate ligament injuries.” Am J Sports Med, 2009;37(5):890–7.