From Pavements to Pitches: How the OKS and Lysholm Scores Transform Knee Recovery in PAAG and Osteoarthritis

Introduction

Knee conditions like Patellofemoral Arthropathy with Anterior Glide (PAAG) and Osteoarthritis (OA) can have a significant impact on daily life. Individuals living with these issues often experience pain, stiffness, and difficulty performing even basic activities — from strolling down pavements to climbing stairs or getting up from a chair. Regaining lost mobility and working towards an active lifestyle becomes a top priority for many.

To help guide this journey, clinicians rely on two key tools: the Oxford Knee Score (OKS) and the Lysholm score. These questionnaires provide a clear way to measure knee function over time and track recovery during treatment. In this article, we’ll break down how these scores work, when they’re used, and the important role they play in moving patients from daily struggles to renewed activity.

Understanding the OKS and Lysholm Scores

Both the OKS and Lysholm scores are simple questionnaires, designed to capture how a patient’s knee is functioning from their own perspective — but they each focus on slightly different aspects of knee health .

The Oxford Knee Score was specifically designed to assess how people feel after knee replacement surgery , but it’s now widely used for all sorts of knee problems, including OA and PAAG. It asks 12 questions about pain and routine activities such as walking, rising from a chair, or climbing stairs. Thanks to its easy format, it gives a clear snapshot of how the knee affects day-to-day living.

The Lysholm score, originally developed for ligament injuries, has since proven useful for a wide range of knee conditions. It examines eight areas like limping, knee support, locking, instability, pain, swelling, and the ability to squat or climb stairs. The Lysholm score is especially valuable in highlighting issues with knee stability during movement.

Extensive research has shown both scores to be reliable and responsive to changes over time. For example, in a recent 24-month study on PAAG treatment for knee OA, researchers found that these questionnaires captured meaningful changes in symptoms and function, helping clinicians track patients’ journeys from initial treatment to longer-term outcomes (Gao et al., 2025).

From Pavements to Pitches: Real-World Impact

Recovery from PAAG or knee OA often starts with the basics: regaining the ability to walk comfortably or stand up without pain. The OKS excels in tracking these early-stage improvements, focusing on comfort and mobility in daily activities.

As therapy progresses, many patients set goals like returning to sports, hiking, or other more demanding activities. At this stage, knee stability — not just reduced pain — becomes crucial. This is where the Lysholm score is especially helpful. It pinpoints whether the knee feels sturdy, or if it buckles, locks, or causes hesitation while moving.

Take, for example, a patient who starts out struggling to walk across a flat driveway. Their OKS will reflect improvements as walking gets easier. As their treatment advances and they tackle activities like jogging, the Lysholm score can reveal gains in knee stability and confidence. Together, these tools offer a step-by-step way for therapists to adjust exercises, set realistic goals, and help patients safely reach higher levels of activity.

In long-term studies of PAAG treatment, researchers saw significant improvements in both symptoms and function, which were measured and validated using these scoring tools (Gao et al., 2025).

OKS vs. Lysholm: When to Use Which?

Though both scores provide important information, each shines in different situations.

The OKS gives a broad, easy-to-understand overview of pain and how the knee impacts daily living. It’s ideal for initial assessments and for tracking general progress in conditions like OA.

The Lysholm score digs deeper into specific issues like joint stability and mechanical symptoms — the kinds of details that matter most in cases of ligament injuries or when evaluating readiness for sports. If someone’s knee feels unstable , the Lysholm score is especially helpful.

In practice, using both scores together offers the most complete picture. If a patient’s OKS isn’t improving as hoped, clinicians might tweak the rehab plan or consider different treatments. When the Lysholm score hits target levels, it often signals that an athlete is ready to return to their sport, or that a patient can safely progress to more vigorous activities.

Looking Ahead: The Future of Knee Function Assessment

New technology is set to make recovery tracking even more thorough. Apps and wearable devices could soon allow patients and providers to monitor OKS and Lysholm progress in real time — supporting more personalized and timely care.

Researchers are also refining these questionnaire tools to make them more sensitive, so they can capture a wider range of experiences across diverse patient groups. This ongoing work means even better, more tailored care for those facing knee problems like PAAG and OA.

There's still more to learn about how best to use these interventions and tools, and further studies are underway to validate their effectiveness, improve patient selection, and measure long-term outcomes (Gao et al., 2025).

Conclusion

The Oxford Knee Score and Lysholm score are more than just numbers — they’re guides that help chart a patient’s path from struggling with basic movements to thriving in active pursuits. By providing clear, reliable feedback on pain, function, and stability, they empower clinicians and patients alike to make smarter decisions at every step.

Together, these tools support more focused rehab, better outcomes, and a smoother journey back to doing the things people love. With technology and research on their side, their role in knee care is only set to grow — helping more people reclaim movement and confidence, whether on the pavement or back on the pitch.