The reliability, validity, and responsiveness of the Lysholm score and Tegner activity scale for anterior cruciate ligament injuries of the knee: 25 years later.
BACKGROUND
In 1982, the Lysholm score was first published as a physician-administered score in the American Journal of Sports Medicine. The Tegner activity scale was published in 1985.


OBJECTIVE
The Lysholm and Tegner scores are valid as patient-administered scores and responsive at early time points after treatment of anterior cruciate ligament tears.


METHODS
Cohort study (Diagnosis); Level of evidence, 1.


METHODS
All patients were treated for an anterior cruciate ligament tear. For responsiveness, the Lysholm score (n = 1075) and Tegner activity level (n = 505) were measured preoperatively and 6, 9, 12, and 24 months postoperatively. For test-retest (n = 50), scores were measured at 2 years postoperatively and again within 4 weeks by questionnaire. For criterion validity (n = 170), patients completed the Short Form-12 and the International Knee Documentation Committee score in addition to Lysholm and Tegner instruments. For all other analyses, preoperative Lysholm score (n = 1783) or Tegner activity levels (n = 687) were collected.


RESULTS
There was acceptable test-retest reliability for both the Lysholm (intraclass correlation coefficient = 0.9) and Tegner (intraclass correlation coefficient = 0.8) scores. The minimum detectable change for Lysholm was 8.9 and for Tegner was 1. The Lysholm demonstrated acceptable internal consistency. The Lysholm correlated with the International Knee Documentation Committee (r = .8) and the Short Form-12 (r = .4), and Tegner correlated with the Short Form-12 (r = .2). Both scores had acceptable floor and ceiling effects and all hypotheses were significant. The Lysholm and Tegner were responsive to change at each of the time points.


CONCLUSIONS
After 25 years of changes in treatment of anterior cruciate ligament injuries, the Lysholm knee score and the Tegner activity scale demonstrated acceptable psychometric parameters as patient-administered scores and showed acceptable responsiveness to be used in early return to function after anterior cruciate ligament treatment.
Briggs
Karen K
KK
Steadman Hawkins Research Foundation, 181 W. Meadow Drive, Vail, CO 81657, USA. Karen.briggs@shsmf.org
Lysholm
Jack
J
Tegner
Yelverton
Y
Rodkey
William G
WG
Kocher
Mininder S
MS
Steadman
J Richard
JR
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D000070598:Anterior Cruciate Ligament Injuries; D005260:Female; D005500:Follow-Up Studies; D006305:Health Status Indicators; D006801:Humans; D007718:Knee Injuries / Q000503:physiopathology / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D011594:Psychometrics; D020127:Recovery of Function; D015203:Reproducibility of Results; D012421:Rupture; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult