Lazansky developed a method for grading pain and function in a patient with a hip disorder. This can be used to evaluate a patient before and after hip surgery. The author is from Albert Einstein College of Medicine in New York City.
NOTE: Lazansky also included grading of mobility when assessing the hip (see next section).
Parameter:
(1) pain
(2) function
(2a) use of walking aids
(2b) walking ability
(2c) gait without aids
(2d) shoes and stockings
(2e) ability to cut toenails
Parameter |
Finding |
Points |
pain |
severe, spontaneous |
1 |
|
severe on attempting to walk, prevents all activity |
2 |
|
tolerable, permitting limited activity |
3 |
|
only after some activity, disappears quickly with rest |
4 |
|
slight or intermittent; pain on starting to walk but getting less with normal activity |
5 |
|
no pain |
6 |
use of walking aid |
bedridden |
1 |
|
chair life |
2 |
|
2 crutches |
3 |
|
2 sticks |
4 |
|
one stick always |
5 |
|
one stick outdoors |
6 |
|
none |
7 |
walking ability |
bedridden or a few yards |
1 |
|
time and distance very limited, with or without sticks |
2 |
|
limited with one stick (less than 1 hour); difficult without stick; able to stand for long periods |
3 |
|
long distances with one stick; limited without stick |
4 |
|
no stick required but limps; little or no limitation on distance |
5 |
|
normal for age and health |
6 |
gait without aids |
cannot walk |
1 |
|
shuffles with small steps or scissors |
2 |
|
walks with gross limp |
3 |
|
walks with moderate limp |
4 |
|
slight limp |
5 |
|
normal gait |
6 |
shoes and stockings |
no |
1 |
|
yes |
2 |
cut toenails |
no |
1 |
|
yes |
2 |
total sum for pain =
= (points for pain in left hip) + (points for pain in right hip)
total score for pain =
= (total sum of pain points) / 2
total sum for all of the functional measures =
= SUM(points for all 6 measures of function)
total score for function=
= SUM(points for all 6 measures) / 4
Interpretation:
• minimum total score for pain: 1
• maximum total score for pain: 6
• minimum sum for function: 5
• maximum sum for function: 23
• minimum total score for function: 1
• maximum total score for function: 5.75
Total Score |
Outcome |
> 5.5 |
excellent |
4.51 to 5.5 |
very good |
3.51 to 4.5 |
good |
2.51 to 3.3 |
fair |
1.51 to 2.5 |
poor |
1.0 to 1.5 |
very poor |
Specialty: Surgery, orthopedic