ACL injury outcome measures still valid

Jul 09, 2009

Even with advances in the way anterior cruciate ligament (ACL) injuries are managed, the Lysholm score and Tegner activity scale are still valid outcome measures more than 25 years after they were developed. Originally used mostly by physicians to measure knee stability and function/activity level, respectively, after injury and surgical repair, the scores are now usually patient-administered.

Even with advances in the way anterior cruciate ligament (ACL) injuries are managed, the Lysholm score and Tegner activity scale are still valid outcome measures more than 25 years after they were developed. Originally used mostly by physicians to measure knee stability and function/activity level, respectively, after injury and surgical repair, the scores are now usually patient-administered.

 Briggs and coworkers reexamined the validity of the scores and determined their responsiveness to change at 6, 9, 12, and 24 months postoperatively. To test responsiveness, they collected preoperative and postoperative Lysholm knee scores and Tegner activity levels from 1783 patients with ACL injury. For reliability (test-retest), scores were measured 2 years postoperatively and again within 4 weeks. For validity, patients completed additional documentation scores.

There was acceptable test-retest reliability for the overall Lysholm score, several domains (eg, instability, pain, stair climbing), and the Tegner activity scale. The Lysholm score had acceptable internal consistency. Both scores had acceptable floor and ceiling effects. The scores were responsive early after ACL treatment.

The authors noted that use of these scores, a generic measure of health-related quality of life, and a measure of patient satisfaction provides a comprehensive outcome assessment for patients with ACL injuries.