Lysholm Knee Questionnaire

Each question refers to your symptoms during the Last 4 weeks.
All fields are required.

Your name *

Your DOB *

Date of filling *

1. Limp *

None

Slight or periodical

Severe and constant

2. Support *

None

Stick or crutch

Weight-bearing impossible

3. Locking *

No locking and no catching sensations

Catching sensation but no locking

Locking Occasionally

Frequently

Locked joint on examination

4. Instability *

Never giving way

Rarely during athletics or other severe exrtion

Frequently during athletics or other seere exertion (or incapable of participation)

Occasionally in daily activities

Often in daily activities

Every step

5. Pain *

None

Inconstant and slight during severe exertin

Marked during severe exertion

Marked on or aften salking more than 2 km

Marked on or aften walking less than 2 km

Constant

6. Swelling *

None

On severe exertion

On ordinary exertion

Constant

7. Stair climbing *

No problems

Slightly impaired

One step at a time

Impossible

8. Squatting *

No problems

Slightly impaired

Not beyond 90°

Impossible

Activity level

Please choose your activity levels before the injury, activity level now and Activity level after surgery (if applicable)

Score

0.00

Lysholm Knee Questionnaire