Briggs Karen K, Kocher Mininder S, Rodkey William G, Steadman J Richard
Department of Clinical Research, Steadman Hawkins Research Foundation, 181 West Meadow Drive, Suite 1000, Vail, CO 81657, USA.
J Bone Joint Surg Am. 2006 Apr;88(4):698-705. doi: 10.2106/JBJS.E.00339.
A torn meniscus is one of the most common indications for knee surgery. The purpose of this study was to determine the psychometric properties of the Lysholm knee score and the Tegner activity scale when used for patients with a meniscal injury of the knee.
Test-retest reliability, content validity, criterion validity, construct validity, and responsiveness to change were determined for the Lysholm score and the Tegner activity scale. Test-retest reliability was measured in a group of 122 patients at least two years after they had undergone surgery for a meniscal lesion. This group completed a follow-up form and then completed it again within four weeks. The other tests were performed in a group of 191 patients who had only a meniscal lesion at the time of the surgery and a group of 477 patients who had a meniscal lesion and other intra-articular lesions.
The overall Lysholm score showed acceptable test-retest reliability, floor and ceiling effects, criterion validity, construct validity, and responsiveness to change. There were unacceptable ceiling effects (>30%) for the Lysholm domains of limp, instability, support, and locking. The Tegner activity scale showed acceptable test-retest reliability, floor and ceiling effects, criterion validity, construct validity, and responsiveness to change.
Overall, the Lysholm knee score and the Tegner activity scale demonstrated acceptable psychometric performances as outcome measures for patients with a meniscal injury of the knee. Some domains of the Lysholm score showed suboptimal performance, and the Tegner scale had only a moderate effect size. Psychometric testing of other condition-specific knee instruments for patients with a meniscal lesion of the knee would be helpful to allow comparison of the properties of the various knee instruments.
半月板撕裂是膝关节手术最常见的指征之一。本研究的目的是确定用于膝关节半月板损伤患者时，Lysholm膝关节评分和Tegner活动量表的心理测量特性。
对Lysholm评分和Tegner活动量表进行重测信度、内容效度、效标效度、结构效度和对变化的反应性测定。在一组122例因半月板损伤接受手术至少两年后的患者中测量重测信度。该组患者填写一份随访表格，然后在四周内再次填写。其他测试在一组手术时仅有半月板损伤的191例患者和一组有半月板损伤及其他关节内损伤的477例患者中进行。
Lysholm评分总体显示出可接受的重测信度、地板效应和天花板效应、效标效度、结构效度以及对变化的反应性。Lysholm评分中跛行、不稳定、支撑和交锁等领域存在不可接受的天花板效应（>30%）。Tegner活动量表显示出可接受的重测信度、地板效应和天花板效应、效标效度、结构效度以及对变化的反应性。
总体而言，Lysholm膝关节评分和Tegner活动量表作为膝关节半月板损伤患者的结局指标，显示出可接受的心理测量性能。Lysholm评分的一些领域表现欠佳，Tegner量表的效应量仅为中等。对膝关节半月板损伤患者的其他特定病情膝关节工具进行心理测量测试，将有助于比较各种膝关节工具的特性。
