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Yilmaz ET, Goymen IM, Oral M, Tuncay O, Dursun G, Turhan E, Tokgozoglu AM. Translation, reliability and validity of the Turkish versions of Norwich Patellar Instability score and The Banff Patellar Instability Instrument 2.0. J Orthop Surg Res 2024; 19:140. [PMID: 38355539 PMCID: PMC10865514 DOI: 10.1186/s13018-024-04612-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 02/01/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Current treatment options for patellofemoral (PF) instability have required functional scoring systems. The Banff Patellar Instability Instrument (BPII) 2.0 and Norwich Patellar Instability (NPI) scores were explicitly created to meet the need to evaluate PF instability. Different patient-reported outcome measurements (PROMs) are used to evaluate anterior knee problems. OBJECTIVES To test the validity and reliability of the Turkish version of the BPII 2.0 and NPI score. STUDY DESIGN AND METHODS Fifty-one patients that operated for PF instability, older than eighteen years old, were included in this study. Turkish translation of the BPII 2.0 and NPI scores was undertaken through translation into Turkish by an independent translator. Two tests were repeated seven days apart. Intraclass correlation coefficient (ICC) was used for test-retest reliability. Internal consistency was analyzed using Cronbach's alpha. Validity was assessed by correlating the Kujala and Lysholm knee scores. RESULTS Fifty-one patients (34 females/17 males), the average age was 25 ± 7, were included in this study. Cronbach's alpha value was 0.829 for BPII 2.0 and 0.843 for NPI for the first time answered by patients. ICC values applied to evaluate test-retest reliability were 0.904 (p < 0.05) for BPII 2.0 and 0.915 (p < 0.05) for NPI. There was a moderate correlation between the BPII 2.0 Turkish version and the Kujala score. There was a very high correlation between the Turkish version of the BPII 2.0 and Lysholm knee scores. An excellent negative correlation was found between Norwich and Kujala scores (r = -0.819, p < 0.05). The correlation coefficient between Norwich and Lysholm scores was -0.662, indicating a high negative correlation (p < 0.05). The correlation coefficients between the Turkish version of BPII 2.0 and NPI were -0.533 (p < 0.05). CONCLUSIONS The Turkish version of the BPII 2.0 and NPI score is a reliable and valid instrument for Turkish-speaking patients with patellofemoral instability.
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Affiliation(s)
- Engin Turkay Yilmaz
- Orthopedics and Traumatology Department, Hacettepe University Medical School, Ankara, Turkey
| | - Ibrahim Mehmet Goymen
- Orthopedics and Traumatology Department, Hacettepe University Medical School, Ankara, Turkey.
| | - Melih Oral
- Orthopedics and Traumatology Department, Hacettepe University Medical School, Ankara, Turkey
| | - Ozan Tuncay
- Orthopedics and Traumatology Department, Hacettepe University Medical School, Ankara, Turkey
| | - Gokay Dursun
- Orthopedics and Traumatology Department, Hacettepe University Medical School, Ankara, Turkey
| | - Egemen Turhan
- Orthopedics and Traumatology Department, Hacettepe University Medical School, Ankara, Turkey
| | - Ahmet Mazhar Tokgozoglu
- Orthopedics and Traumatology Department, Hacettepe University Medical School, Ankara, Turkey
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Von Heideken J, Iversen MD, Hellsten A, Askenberger M. Adaptation of the Banff Patellofemoral Instability Instrument (BPII) 2.0 into Swedish. Acta Orthop 2023; 94:537-542. [PMID: 37905565 PMCID: PMC10617520 DOI: 10.2340/17453674.2023.21194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 07/07/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND AND PURPOSE The Banff Patellofemoral Instability Instrument (BPII) 2.0 is a patient-reported outcome measure (PROM) designed specifically for patellofemoral instability. We translated and adapted the BPII 2.0 into Swedish and assessed its psychometric properties. PATIENTS AND METHODS The BPII 2.0 was forward- and back-translated. Children aged 10-16 years with patellar dislocation and instability or recurrent dislocation were recruited. Children completed the Swedish BPII 2.0 and KOOS-Child during their initial visit (t0) and 1 week later (t1). Internal consistency and test-retest reliability were evaluated using intraclass correlation coefficients (ICCs) for the BPII 2.0 and KOOS-Child scores comparison. Pearson correlation coefficients examined concurrent validity of the Swedish BPII 2.0 subscales with KOOS-Child subscales. RESULTS 64 children (46 females), mean age 13.8 (10.0-16.3) years, participated. Time after patellar dislocation or surgery was 3-24 months. 55 patients (86%) returned the second BPII 2.0 and KOOS-Child after an average of 9 (5-22) days. There were no ceiling or floor effects for the total score of the new Swedish BPII 2.0 or for its subscales. BPII 2.0 demonstrated excellent internal consistency at t0 (ICC 0.96, 95% confidence interval [CI] 0.95-0.97) and at t1 (ICC 0.97, CI 0.95-0.98), as well as excellent test-retest reliability (ICC 0.97, CI 0.96-0.98). Concurrent validity of the BPII 2.0 subscales with KOOS-Child subscales was moderate to strong (rho 0.40-0.88). CONCLUSION The Swedish BPII 2.0 showed excellent internal consistency as well as excellent test-retest reliability and is a reliable and valid questionnaire.
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Affiliation(s)
- Johan Von Heideken
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Maura D Iversen
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; Brigham & Women's Hospital, Division of Rheumatology, Immunology & Immunity, Section of Clinical Sciences, and Department of Medicine, Harvard Medical School, Boston, USA
| | | | - Marie Askenberger
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
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Hysing-Dahl T, Magnussen LH, Faleide AGH, Kjellsen AB, Mo IF, Waaler PAS, Mundal R, Inderhaug E. Cross-cultural Validation of the Norwegian Version of the Banff Patellofemoral Instability Instrument 2.0. Orthop J Sports Med 2023; 11:23259671231168881. [PMID: 37346778 PMCID: PMC10280527 DOI: 10.1177/23259671231168881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 02/09/2023] [Indexed: 06/23/2023] Open
Abstract
Background The Banff Patellofemoral Instability Instrument (BPII) 2.0 is a disease-specific quality of life questionnaire for patients with patellofemoral instability. While good psychometric properties have been demonstrated, the data lack cross-cultural validity, construct validity, and an established measurement error. Purpose To (1) translate and cross-culturally adapt the BPII 2.0 to the Norwegian version (BPII 2.0-No) and (2) examine the psychometric properties of the Norwegian version. Study Design Cohort study (diagnosis); Level of evidence, 3. Methods The BPII 2.0 was translated according to international guidelines. A cohort of 100 patients surgically treated for recurrent patellofemoral instability completed the BPII 2.0-No, related outcome measures (Norwich Patellar Instability Score, International Knee Documentation Committee Subjective Knee Form 2000, Knee injury and Osteoarthritis Outcome Score, and Tampa Scale of Kinesiophobia), and functional tests (Y-Balance Test-Lower Quarter, single-leg hop tests, and knee extension strength) before and/or 6 months after surgery. We evaluated the face and content validity, internal consistency (Cronbach α), test-retest reliability (intraclass correlation coefficient [ICC]), measurement error (SEM and smallest detectable change at the individual [SDCind] and group levels [SDCgroup]). Construct validity was assessed by testing 9 hypotheses on the correlation between the BPII 2.0-No and the outcome measures/functional tests (Pearson r). Results The BPII 2.0-No had good face and content validity. Internal consistency was excellent (α = .95), and no floor or ceiling effects were found. Test-retest reliability was high (ICC2,1 = 0.87; 95% CI, 0.77-0.93), and measurement error was low (SEM = 7.1). The SDCind was 19.7 points and the SDCgroup was 2.8 points. Eight of the 9 hypotheses regarding construct validity were confirmed. Conclusion The BPII 2.0-No was found to be valid and reliable. This study adds further knowledge on the measurement properties of the BPII 2.0 that can be used internationally.
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Affiliation(s)
- Trine Hysing-Dahl
- Haraldsplass Deaconess Hospital,
Bergen, Norway
- University of Bergen, Bergen,
Norway
| | | | | | | | | | | | | | - Eivind Inderhaug
- University of Bergen, Bergen,
Norway
- Haukeland University Hospital, Bergen,
Norway
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Rhatomy S, Pontoh LA, Phatama KY, Waskita HC, Al Mashur MI, Fiolin J, Rasyid FA, Utomo DN, Dilogo IH. The Banff Patellar Instability Instrument: validity and reliability of an Indonesian version. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY & TRAUMATOLOGY : ORTHOPEDIE TRAUMATOLOGIE 2023; 33:617-622. [PMID: 35931873 DOI: 10.1007/s00590-022-03336-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 07/01/2022] [Indexed: 10/15/2022]
Abstract
BACKGROUND The Banff Patellar Instability Instrument (BPII) is a valuable scoring tool for assessing patellofemoral instability in patients suffering from patellofemoral pain syndrome (PFPS). The BPII 2.0 is a shortened version of the BPII. However, there is no Indonesian edition of BPII 2.0 that has been validated. This study aimed to determine the validity and reliability of the Indonesian version of the BPII 2.0. MATERIALS AND METHODS This was a cross-sectional study that used a forward-backward translation protocol to create an Indonesian version of the BPII 2.0. Thirty patients with PFPS were given the questionnaires. The questionnaire's validity was evaluated by analyzing the correlation between score of each subscale and the overall score to the Indonesian version of the Kujala score using Pearson correlation coefficient, while the reliability was evaluated by measuring the internal consistency (Cronbach α) and test-retest reliability (intraclass correlation coefficient). RESULTS The Indonesian version of BPII 2.0 and the Indonesian version of Kujala score had a strong Pearson correlation coefficient for construct validity. For all subscales, Cronbach α was 0.90-0.98, indicating adequate internal consistency. The test-retest reliability was high, with intraclass correlation coefficient ranging from 0.89 to 0.98 for all subscales. There was no difference in the Indonesian version of BPII 2.0 response between the first and second administration of the questionnaire which was taken 7 days afterward. CONCLUSION The Indonesian version of BPII 2.0 was determined to be valid and reliable and is therefore an objective instrument to evaluate patellofemoral instability in patients with PFPS in the Indonesian population.
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Affiliation(s)
- Sholahuddin Rhatomy
- Department of Orthopaedic and Traumatology, Soeradji Tirtonegoro Hospital, Klaten, Faculty of Medicine, Public Health of Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
| | - Ludwig Andre Pontoh
- Department of Orthopaedic and Traumatology, Fatmawati General Hospital, Faculty of Medicine, Universitas Indonesia, Jl. RS Fatmawati No. 4, Jakarta Selatan, 12430, Indonesia
| | - Krisna Yuarno Phatama
- Department of Orthopaedics and Traumatology, Faculty of Medicine, Universitas Brawijaya-Saiful Anwar General Hospital, Jl. Veteran, Ketawanggede, Kota Malang, Jawa Timur, 65145, Indonesia
| | - Heppy Chandra Waskita
- Orthopaedic Surgeon of Lira Medika Karawang Hospital, Jl. Raya Syeh Quro No. 14, Palumbonsari, Jawa Barat, 41314, Indonesia
| | - Muslich Idris Al Mashur
- General Practitioner of UGM Academic Hospital, Jl. Kabupaten, Kranggahan I, Trihanggo, Daerah Istimewa Yogyakarta, 55291, Indonesia
| | - Jessica Fiolin
- Orthopaedic Surgeon of Jakarta Knee, Shoulder and Orthopaedic Sport Clinic, Pondok Indah General Hospital, Jl. Metro Duta Kav UE, Jakarta Selatan, 12310, Indonesia
| | - Faiz Alam Rasyid
- Orthopaedic and Traumatology Department, Faculty of Medicine, Brawijaya University, Jl. Veteran, Ketawanggede, Kota Malang, Jawa Timur, 65145, Indonesia
| | - Dwikora Novembri Utomo
- Orthopaedic and Traumatology Department, Faculty of Medicine, Dr Soetomo General Hospital, Surabaya, Universitas Airlangga, Jl. Airlangga 4-6, Surabaya, 60286, Indonesia
| | - Ismail Hadisoebroto Dilogo
- Orthopaedic and Traumatology Department, Faculty of Medicine, RS DR Cipto Mangunkusumo, Jakarta, Jl. Diponegoro no 71, Jakarta, Indonesia
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Zimmermann F, Milinkovic DD, Zimmerer A, Balcarek P. When Should Bony Correction Be Considered in Addition to Medial Patellofemoral Ligament Reconstruction? Results of a Clinically Derived 2-Group Classification of Lateral Patellar Instability Based on 122 Patients at 2- to 5-Year Follow-up. Orthop J Sports Med 2023; 11:23259671221147572. [PMID: 36743734 PMCID: PMC9893382 DOI: 10.1177/23259671221147572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 10/21/2022] [Indexed: 01/29/2023] Open
Abstract
Background The need for concomitant bony procedures to realign pathoanatomic risk factors in addition to medial patellofemoral ligament reconstruction (MPFL-R) remains unclear. Purpose To evaluate a clinically derived 2-part classification of lateral patellar instability aimed at identifying patients indicated for a concomitant bony procedure. Study Design Cohort study; Level of evidence, 3. Methods The study included 122 patients (42 male, 80 female; mean ± SD age, 22 ± 6 years) who were assigned to a mild instability group (mIG) and a complex instability group (cIG) based on the reversed dynamic patellar apprehension test (ReDPAT) and J-sign. The mIG had a positive ReDPAT result <40° to 50° of knee flexion and an absent or low-grade J-sign (grade 1), and the cIG had a positive ReDPAT result >40° of knee flexion and/or a high-grade J-sign (grade 2 or 3). The mIG underwent isolated MPFL-R, and the cIG underwent MPFL-R and concomitant bony procedures depending on the established risk factor assessment. For evaluation, the BANFF Patellar Instability Instrument 2.0 (BPII 2.0) and numeric analog scale (0-10) for patellofemoral pain and subjective knee function were used. The minimal clinically important difference for the BPII 2.0 was ascertained by calculating half the standard deviation of baseline scores. Results Radiographic analysis confirmed a significantly more pronounced pathoanatomic risk factor constellation in the cIG regarding severity of trochlear dysplasia, distal malalignment, and patellar height (all P < .05). At final follow-up, no patellar redislocation occurred in either group; 2 patients in the cIG reported patellar subluxation. Within both groups, all outcome scores improved significantly pre- to postoperatively (all P < .0001); no between-group difference was found regarding BPII 2.0 score and numeric analog scale for function. The minimal clinically important difference for the BPII 2.0 was met by 84% (32/38) of the mIG and 90% (76/84) of the cIG (P = .36), but the cIG experienced more patellofemoral pain than the mIG (1.3 ± 1.6 vs 2.1 ± 2.1; P = .036). Conclusion Patients with a high-grade J-sign and/or a positive ReDPAT finding beyond 40° to 50° of knee flexion exhibited a significantly more pronounced pathoanatomic risk factor constellation; however, the correction of modifiable risk factors led to similarly good outcomes to patients who underwent isolated MPFL-R. A slightly higher level of patellofemoral pain after bony procedures was evident in these patients.
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Affiliation(s)
| | | | | | - Peter Balcarek
- Arcus Sportklinik, Pforzheim, Germany.,Department of Trauma Surgery, Orthopaedics and Plastic Surgery,
University of Göttingen, Göttingen, Germany.,Peter Balcarek, MD, Arcus Sportklinik, 75179 Pforzheim, Germany
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Milinkovic DD, Zimmermann F, Balcarek P. Medial patellofemoral ligament reconstruction using nonresorbable sutures yields comparable outcomes to reconstruction with a pedicled quadriceps tendon autograft when performed in addition to bony risk factor correction. Knee Surg Sports Traumatol Arthrosc 2023; 31:264-271. [PMID: 35972519 PMCID: PMC9859873 DOI: 10.1007/s00167-022-07104-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 08/03/2022] [Indexed: 01/25/2023]
Abstract
PURPOSE To evaluate the results for reconstruction of the medial patellofemoral ligament using synthetic nonresorbable sutures (S-MPFL-R) in comparison to MPFL-R using quadriceps tendon autograft (QT-MPFL-R) in patients undergoing simultaneous correction of anatomic risk factors for lateral patellar instability (LPI) at a minimum of 2 years of follow-up. METHODS Between November 2018 and June 2019, 19 patients (male/female 8/11; mean age 26 ± 7 years) underwent S-MPFL-R (FiberTape®) in combination with the correction of predisposing risk factors for LPI. The control group of 38 patients (male/female 16/22, mean age 26 ± 6 years) who underwent QT-MPFL-R was matched 1:2 by sex, age, anatomic risk factors, and concomitant surgical correction of bony risk factors. The Banff Patella Instability Instrument 2.0 (BPII 2.0) and a numerical analog scale (NAS 0-10) for patellofemoral pain and subjective knee joint function were used to assess patients' reported quality of life before and after surgery. RESULTS The BPII 2.0 score increased from 35.0 ± 21.7 points to 79.7 ± 13.3 points (p < 0.0001) in the S-MPRL-R group and from 44.3 ± 19.6 points to 80.9 ± 15 points (p < 0.0001) in the QT-MPFL-R group from preoperatively to postoperatively, respectively, without any significant difference between the groups. In the S-MPFL-R group and QT-MPFL-R group, 95% (18/19) and 92% (35/38) of patients, respectively, crossed the minimally clinically important difference reported for the BPII 2.0. NAS values for pain and subjective knee joint function improved significantly in both groups (p < 0.0001, p < 0.0001) without any significant difference between the groups at the final follow-up. CONCLUSIONS This study demonstrates that nonresorbable sutures can serve as a viable option for MPFL-R, yielding comparable outcomes compared to quadriceps tendon autograft reconstruction when performed concomitantly with the correction of anatomic risk factors for LPI. This option reduces the need for autologous tendon harvesting or the use of allografts for MPFL-R. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Danko Dan Milinkovic
- Center for Musculoskeletal Surgery, Charité-University Medicine Berlin, Luisenstrasse 64, 10117, Berlin, Germany.
| | - Felix Zimmermann
- Berufsgenossenschaftliche Unfallklinik Ludwigshafen, Ludwigshafen am Rhein, Germany
| | - Peter Balcarek
- Arcus Sportklinik, Pforzheim, Germany ,Department of Trauma Surgery, Orthopaedics, and Plastic Surgery, University Medicine Göttingen, Göttingen, Germany
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Balcarek P, Milinkovic DD, Zimmerer A, Zimmermann F. Mental and physical health-related quality of life in patients with recurrent patellar dislocations-a generic and disease-specific quality of life questionnaire assessment. J Exp Orthop 2022; 9:60. [PMID: 35764849 PMCID: PMC9240127 DOI: 10.1186/s40634-022-00499-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 06/16/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose There is a paucity of quality of life (QoL) assessments in studies evaluating patients treated for recurrent lateral patellar dislocation (LPD). The primary aim of this study was to investigate whether mental well-being is impaired in patients with chronic (recurrent) LPD and, if so, to assess whether the mental health-related QoL dimension improves equivalently to the physical-related QoL dimension after successful surgical treatment. Methods Thirty-eight patients with recurrent LPD over a mean course of the disease of 4.7 ± 3.9 years (1—18 years) prior to surgery were included. Generic health-related QoL (HRQoL) (Short Form 36; SF-36) and disease-specific QoL (Banff Patella Instability Instrument 2.0; BPII 2.0) were assessed preoperatively and after a mean follow-up of 3.5 ± 0.8 years (2 – 5 years) postoperatively. Results Untreated LPD significantly impacted the physical dimension of patients’ generic HRQoL and their disease-specific QoL. When compared to age-equivalent normative data sets, the mental HRQoL dimension was not reduced prior to operative treatment but increased during the follow-up period. Surgical treatment normalized the physical dimension of patients’ generic HRQoL and significantly improved their disease-specific QoL. However, BPII 2.0 values remained reduced, albeit patellae were successfully stabilized. Conclusion The results of this study indicate that patients with recurrent LPD are generally in good mental health, although physical impairment is striking. Notwithstanding that surgery prevented further dislocations and normalized the generic HRQoL, the disease-specific QoL remained reduced as far as this can be interpreted without population-based data. Level of evidence Level IV; Retrospective case series.
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Affiliation(s)
- Peter Balcarek
- Arcus Sportklinik, Pforzheim, Germany.,Department of Trauma Surgery, Orthopaedics, and Plastic Surgery, University Medicine Göttingen, Göttingen, Germany
| | - Danko Dan Milinkovic
- Center for Musculoskeletal Surgery, Charité-Universitaetsmedizin Berlin, Campus Mitte, Charitéplatz 1, 10117, Berlin, Germany
| | | | - Felix Zimmermann
- Berufsgenossenschaftliche Unfallklinik Ludwigshafen, Ludwig-Guttmann-Straße 13, 67071, Ludwigshafen am Rhein, Germany.
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Zimmermann F, Milinkovic DD, Börtlein J, Balcarek P. Revision surgery for failed medial patellofemoral ligament reconstruction results in better disease-specific outcome scores when performed for recurrent instability than for patellofemoral pain or limited range of motion. Knee Surg Sports Traumatol Arthrosc 2022; 30:1718-1724. [PMID: 34491379 DOI: 10.1007/s00167-021-06734-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 08/30/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Medial patellofemoral ligament reconstruction (MPFL-R) is an important treatment for recurrent patellar instability. Although complications such as redislocation, patellofemoral pain (PFP) and restricted knee range of motion have been reported, few studies have investigated the results of revision surgery for failed MPFL-R. Thus, the aim of this study was to determine the results of the tailored revision surgery after considering the cause of the reconstruction failure. MATERIALS AND METHODS Between 2015 and 2019, 28 patients (male/female 9/19; age 26.2 ± 6.4 years) underwent revision surgery for failed MPFL-R. The patients were grouped into the "recurrent instability" (SG1) group and "PFP" and/or "restricted range of motion" (SG2) group. Preoperatively, the clinical data, anatomical risk factor profile, and position of the femoral MPFL tunnel were determined for each patient. The Banff Patella Instability Instrument 2.0 (BPII 2.0) and numerical analogue scale (NAS 0-10) were administered preoperatively and at the final follow-up for the subjective assessment of the PFP and knee joint function. RESULTS Overall, the BPII 2.0 score improved from 28.8 ± 16.6 points preoperatively to 68.0 ± 22.7 points (p < 0.0001) postoperatively. SG1 exhibited an increase in the BPII 2.0 score from 28.9 ± 20.2 points to 75.7 ± 23 points (p < 0.0001). PFP decreased from 6.8 ± 2.4 to 1.6 ± 1.9 (p < 0.0001), while the knee joint function increased from 4.3 ± 2.5 to 8.8 ± 1.6 (p < 0.0001). In SG2, the BPII 2.0 score increased from 28.7 ± 12.6 points preoperatively to 57.7 ± 19.7 points (p = 0.0002) postoperatively and was thus significantly lower than that in SG1 (p = 0.038). The intensity of PFP decreased from 6.6 ± 3.0 preoperatively to 2.1 ± 1.9 postoperatively (p = 0.0006), while the subjective knee joint function improved from 3.2 ± 1.4 preoperatively to 7.6 ± 2.3 postoperatively (p < 0.0001). The differences between the groups were not significant. CONCLUSION Tailored revision surgery for failed MPFL-R significantly improves the patient-reported disease-specific quality of life. The study results indicate that patients undergoing revision surgery as a consequence of patellar redislocation appear to benefit more from revision surgery than those patients undergoing revision due to postoperative PFP and/or a limited knee joint range of motion. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
- Felix Zimmermann
- BG Klinik Ludwigshafen, Ludwig-Guttmann-Straße 13, 67071, Ludwigshafen am Rhein, Germany.
| | | | | | - Peter Balcarek
- Arcus Sportklinik, Pforzheim, Germany.,Abteilung für Unfallchirugie, Orthopädie und Plastische Chirurgie, Universitätsmedizin Göttingen, Göttingen, Germany
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Milinkovic DD, Jovandic I, Zimmermann F, Balcarek P. The J-sign and the body mass index determine the disease-specific quality of life in patients with lateral patellar instability. Knee Surg Sports Traumatol Arthrosc 2022; 30:1672-1678. [PMID: 34424355 DOI: 10.1007/s00167-021-06705-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 08/16/2021] [Indexed: 01/26/2023]
Abstract
PURPOSE To determine which risk factors for patellar instability contribute most relevantly to patients' subjective disease-specific quality of life, aiming to provide implications on the overall treatment decision-making process. METHODS A total of 182 consecutive patients (male/female 70/112; mean age 23.6 ± 7.3 years) with a history of patellar instability were prospectively enrolled in this study. Patient age, body mass index (BMI), number of dislocations, reversed dynamic patellar apprehension test (ReDPAT), J-sign severity, and pathoanatomic risk factors of patellar instability were assessed. The statistical analysis evaluated the relationships among those variables and determined their ability to predict the Banff Patellofemoral Instability Instrument 2.0 (BPII 2.0) as a disease-specific quality of life measure. Using Spearman correlation, ANOVA and Fisher's exact test, all variables with ANOVA p ≤ 0.1 or Spearman's abs (rho) > 0.1 were entered into a multivariate linear model using backward-stepwise selection. RESULTS Analysis of the individual variables' ability to predict BPII 2.0 score values revealed 'age', 'BMI', 'ReDPAT', 'high grade of trochlear dysplasia', and 'high-grade J-Sign' as possible relevant factors. Backward-stepwise multivariate regression analysis yielded a final parsimonious model that included the factors 'BMI' and 'J-Sign (Grade II and III)' as the most relevant parameters influencing BPII 2.0 score values (adjusted R2 = 0.418; p < 0.001), with a cutoff value for BMI found at 28 kg/m2 (p = 0.01). CONCLUSION The results of this study indicate that in patients with lateral patellar instability, a high-grade J-sign and an increased BMI significantly impact subjective disease-specific quality of life. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
| | - Isidora Jovandic
- Group for Econometric Analysis, Statistical Office of the Republic of Serbia, Belgrade, Serbia
| | - Felix Zimmermann
- Berufsgenossenschaftliche Unfallklinik Ludwigshafen, Ludwigshafen am Rhein, Germany
| | - Peter Balcarek
- Arcus Sportklinik, Rastatter Str. 17-19, 75179, Pforzheim, Germany.,Department of Trauma Surgery, Orthopaedics, and Plastic Surgery, University Medicine Göttingen, Göttingen, Germany
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Herbst E, Günther D, Ackermann J, Lattermann C, Mathis D, Schüttler KF, Wafaisade A, Eggeling L, Akgün D, Rössler P, Laky B, Kopf S. Empfehlung für Fragebögen zur klinischen und subjektiven Untersuchung der Kniegelenksfunktion vom Research-Komitee der AGA. ARTHROSKOPIE 2022. [DOI: 10.1007/s00142-022-00538-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Mengis N, Zimmermann F, Schemel L, Rippke JN, Milinkovic DD, Balcarek P. Return to Sports and Patients' Rehabilitation Continuum After Deepening Trochleoplasty and Concomitant Patellar-Stabilizing Procedures: A Case Series of 111 Patients at 2 to 4 Years of Follow-up. Am J Sports Med 2022; 50:674-680. [PMID: 35144479 DOI: 10.1177/03635465211063914] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND There are few reports on the return to sports after complex patellar-stabilizing surgery. PURPOSES To evaluate patients' ability to return to sports and to investigate the extent to which the preoperative level of sports participation influences sports activity after deepening trochleoplasty (TP) and concomitant patellar-stabilizing procedures. STUDY DESIGN Case series; Level of evidence, 4. METHODS Between April 2015 and April 2019, 144 patellar-stabilizing procedures, including deepening TP and medial patellofemoral ligament reconstruction or medial reefing with and without concomitant realignment procedures, were carried out in 142 patients. The Banff Patellofemoral Instability Instrument 2.0 (BPII 2.0) and the Tegner activity score were used to assess patients' quality of life and sports activity level. In addition, a numerical analog scale was used to evaluate patellofemoral pain intensity during rest and activity and subjective knee joint function. RESULTS Outcomes were available for 111 patients (112 knees) (male/female, 77/34; mean age, 23.4 ± 7.8 years), yielding a 77.7% follow-up rate at a mean of 39.2 ± 9.9 months (range, 24-48 months). Two-thirds of the patients returned to their preoperative level of activity or higher, but their Tegner scores did not change significantly (4.5 ± 2.4 vs 4.7 ± 1.6; P = .365). Low-level athletes (preoperative Tegner score 0-4) participated at a higher level of sports activity (2.7 ± 1.4 to 4.1 ± 1.2; P < .0001), whereas higher-level athletes (preoperative Tegner score 5-10) participated at a lower level (6.8 ± 1.3 to 5.5 ± 1.7; P < .0001). The likelihood of returning to the preoperative activity level (Tegner score) was significantly higher in the low-level activity group than in the high-level activity group (P = .0001; 95% CI, 4.055-27.05; odds ratio, 10.47). All of the patient-reported outcome measures improved postoperatively, independent of the patients' age, sex, and body mass index. CONCLUSION Patients undergoing deepening TP and medial soft tissue stabilization with or without concomitant realignment surgery for complex patellar instability can expect good clinical results and a high rate of return to sports participation, with two-thirds of patients returning to their preoperative Tegner-level of activity or higher. However, higher-level athletes should be informed that their likelihood of returning to sports at the preoperative level or full participation at a competitive level is reduced.
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Affiliation(s)
| | | | | | | | | | - Peter Balcarek
- Arcus Sportklinik, Pforzheim, Germany.,Department of Trauma Surgery, Orthopaedics and Plastic Surgery, University of Göttingen, Göttingen, Germany
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Horstmann H, Karkosch R, Berg A, Becher C, Petri M, Smith T. The novel dynamic MPFL-reconstruction technique: cheaper and better? Arch Orthop Trauma Surg 2022; 142:2011-2017. [PMID: 34633513 PMCID: PMC9296410 DOI: 10.1007/s00402-021-04198-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 09/28/2021] [Indexed: 01/24/2023]
Abstract
PURPOSE Reconstruction of the medial patellofemoral ligament (MPFL) is an established procedure to restore patellar stability. Aim of this study is to evaluate the results of a dynamic MPFL reconstruction technique in a large university hospital setting. METHODS Two hundred and thirteen consecutive patients with 221 knees were surgically treated for recurrent lateral patellar dislocation. All patients obtained dynamic reconstruction of the MPFL with detachment of the gracilis tendon at the pes anserinus while maintaining the proximal origin at the gracilis muscle. Patellar fixation was performed by oblique transpatellar tunnel transfer. Follow-up data including Kujala and BANFF score, pain level as well as recurrent patella instability were collected at a minimum follow-up of 2 years. RESULTS Follow-up could be obtained from 158 patients (71%). The mean follow-up time was 5.4 years. Mean pain level was 1.9 ± 2.0 on the VAS. Mean Kujala score was 78.4 ± 15.5. Mean BANFF score was 62.4 ± 22.3. MPFL-reconstructions that were performed by surgeons with a routine of more than ten procedures had a significantly shorter surgical time 52.3 ± 17.6 min. Male patients yielded higher satisfaction rates and better clinical scores compared to females. Complications occurred in 27.2% of procedures, 20.9% requiring revision surgery of which were 9.5% related to recurrent patellar instability. 78% of all patients indicated they would undergo the procedure again. CONCLUSION Dynamic MPFL reconstruction presents a reproducible procedure with increased complication rates, inferior to the results of static reconstruction described in the literature. Despite, it appears to be an efficient procedure to restore patellar stability in a large university hospital setting, without the necessity for intraoperative fluoroscopy. TRIAL REGISTRATION The study was registered in ClinicalTrials.gov with the registration number NCT04438109 on June 18th 2020.
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Affiliation(s)
- Hauke Horstmann
- Department of Orthopaedic Surgery, Diakovere Annastift, Hannover Medical School, Anna-von-Borries-Str. 1-7, 30625 Hannover, Germany
| | - Roman Karkosch
- Department of Orthopaedic Surgery, Diakovere Annastift, Hannover Medical School, Anna-von-Borries-Str. 1-7, 30625 Hannover, Germany
| | - Annika Berg
- Department of Orthopaedic Surgery, Diakovere Annastift, Hannover Medical School, Anna-von-Borries-Str. 1-7, 30625 Hannover, Germany
| | - Christoph Becher
- Center for Hip, Knee and Foot Surgery, ATOS Clinic Heidelberg, 69115 Heidelberg, Germany
| | - Maximilian Petri
- Department of Orthopaedic Surgery, Diakovere Annastift, Hannover Medical School, Anna-von-Borries-Str. 1-7, 30625 Hannover, Germany
| | - Tomas Smith
- Department of Orthopaedic Surgery, Diakovere Annastift, Hannover Medical School, Anna-von-Borries-Str. 1-7, 30625 Hannover, Germany
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Galvão PHSAF, Marques DS, Gracitelli GC, Ferreira MDC, Kubota MS, Franciozi CEDS. Portuguese Translation and Cross-Cultural Adaption of the Banff Patella Instability Instrument. Rev Bras Ortop 2021; 56:747-760. [PMID: 34900103 PMCID: PMC8651449 DOI: 10.1055/s-0040-1721840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 09/16/2020] [Indexed: 11/21/2022] Open
Abstract
Objective
To translate into Brazilian Portuguese and to cross-culturally adapt the Banff Questionnaire for Patellar Instability.
Methods
The translation and cross-cultural adaptation followed the linguistic validation process proposed by international guidelines, which consists of six steps: translation, synthesis, back-translation, review by an expert committee, pretest, and final report presentation to the authors of the original questionnaire. Literate patients with recurrent patellar instability, older than 12 years of age, who signed the informed consent form or had it signed by a legal guardian were included in the study. Patients with neurological or systemic comorbidities were excluded from the study.
Results
A total of 62 patients (18 males and 44 females) were included in the study. Discrepancies observed during the processes of translation and harmonization of the back-translations were modified with no need for reformulation. No pretest version replacements were required.
Conclusion
The Banff Questionnaire for Patellar Instability has been successfully translated and cross-culturally adapted into Brazilian Portuguese, so it can be used to assess patients with patellar instability who speak this language.
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Affiliation(s)
| | - Dayane Screpante Marques
- Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | - Guilherme Conforto Gracitelli
- Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | | | - Marcelo Seiji Kubota
- Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
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Balcarek P. [Primary and recurrent patellar dislocation: recommendation for diagnostic evaluation, risk stratification and treatment]. SPORTVERLETZUNG-SPORTSCHADEN 2021; 35:185-193. [PMID: 34883518 DOI: 10.1055/a-1667-2241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The dogma that (every) primary patellar dislocation should be treated non-operatively is considered outdated. Therefore, every first-time dislocation, as well as every recurrent dislocation, should be fully diagnosed with regard to the injury pattern and anatomically predisposing risk factors. This enables the use of risk stratification models to assess the risk of recurrent episodes of instability, thereby supporting the clinical decision-making process. The reconstruction of the MPFL can be considered an established and successful treatment strategy for patellar instability. However, the additional correction of bony risk factors is often useful. In this context, the preoperative grading of the J sign and dynamic assessment of patellar instability (dynamic apprehension test) are of utmost importance. These findings, combined with the radiographic imaging findings, can be used as a clinical decision aid for a bony correction procedure.
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Conservative versus tailored surgical treatment in patients with first time lateral patella dislocation: a randomized-controlled trial. J Orthop Surg Res 2021; 16:378. [PMID: 34120628 PMCID: PMC8199830 DOI: 10.1186/s13018-021-02513-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 06/01/2021] [Indexed: 11/12/2022] Open
Abstract
Background Patellar instability has a high incidence and occurs particularly in young and female patients. If the patella dislocates for the first time, treatment is usually conservative. However, this cautious approach carries the risk of recurrence and of secondary pathologies such as osteochondral fractures. Moreover, there is also risk of continuous symptoms apparent, as recurrent patella dislocation is related to patellofemoral osteoarthritis as well. An initial surgical treatment could possibly avoid these consequences of recurrent patella dislocation. Methods A prospective, randomized-controlled trial design is applied. Patients with unilateral first-time patella dislocation will be considered for participation. Study participants will be randomized to either conservative treatment or to a tailored patella stabilizing treatment. In the conservative group, patients will use a knee brace and will be prescribed outpatient physical therapy. The surgical treatment will be performed in a tailored manner, addressing the pathologic anatomy that predisposes to patella dislocation. The Banff Patellofemoral Instability-Instrument 2.0, recurrence rate, apprehension test, joint degeneration, and the Patella Instability Severity Score will serve as outcome parameters. The main analysis will focus on the difference in change of the scores between the two groups within a 2-year follow-up. Statistical analysis will use linear mixed models. Power analysis was done for the comparison of the two study arms at 2-year follow-up with regard to the BPII Score. A sample size of N = 64 per study arm (128 overall) provides 80% power (alpha = 0.05, two-tailed) to detect a difference of 0.5 standard deviations in a t-test for independent samples. Discussion Although several studies have already dealt with this issue, there is still no consensus on the ideal treatment concept for primary patellar dislocation. Moreover, most of these studies show a unified surgical group, which means that all patients were treated with the same surgical procedure. This is regarded as a major limitation as surgical treatment of patella dislocation should depend on the patient’s anatomic pathologies leading to patellar instability. To our knowledge, this is the first study investigating whether patients with primary patella dislocation are better treated conservatively or operatively with tailored surgery to stabilize the patella. Trial registration The study will be prospectively registered in the publicly accessible database www.ClinicalTrials.gov.
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Complex patellofemoral reconstruction leads to improved physical and sexual activity in female patients suffering from chronic patellofemoral instability. Knee Surg Sports Traumatol Arthrosc 2021; 29:3017-3024. [PMID: 33119832 PMCID: PMC8384801 DOI: 10.1007/s00167-020-06340-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 10/15/2020] [Indexed: 12/17/2022]
Abstract
PURPOSE To analyze postoperative physical and sexual activity as well as Quality of Life (QoL) after complex patellofemoral reconstructions in female patients suffering from chronic patellofemoral instability (PFI). METHODS Female patients aged > 18 years undergoing complex patellofemoral reconstruction for chronic PFI were included. Complex patellofemoral reconstruction was defined as medial patellofemoral ligament reconstruction (MPFL-R) combined with at least one major bony procedure (distal femoral osteotomy, high tibial osteotomy, and trochleoplasty). Outcome was evaluated retrospectively after a minimum follow-up of 12 months using Tegner activity scale, Banff Patellofemoral Instability Instrument 2.0 (BPII 2.0), EuroQol-5D-3L (EQ-5D-3L), EuroQol Visual analog scale (EQ-VAS), and a questionnaire about sexual activity. RESULTS A total of 34 females (mean age, 26 ± 5 years) with a mean follow-up of 45 ± 16 months were included. Seventy-seven percent had one major bony correction + MPFL-R and 24% had at least two major bony corrections + MPFL-R. The re-dislocation rate was 6%. Median Tegner activity scale improved from 3 (range 0-10) to 4 (range 2-6) (n.s.) and an improved activity level was observed in 49% of subjects. QoL scores showed an EQ-5D-3L Index Value of 0.89 ± 0.15, EQ-VAS of 80.3 ± 11.4, and BPII of 68.3 ± 19.1. Thirty-four percent of patients reported restrictions of sexual activities due to PFI preoperatively with an improved sexual function observed in 60% postoperatively due to less pain, improved mobility, and less apprehension. Postoperative return to sexual activity was 91%, whereof 19% reported current restrictions of sexual function because of pain and/or limited range of motion. CONCLUSION Despite the complexity and invasiveness of complex patellofemoral reconstruction, combined bony procedures and MPFL-R resulted in a low redislocation rate, improved physical activity and QoL comparable to values reported after isolated MPFL-R. Furthermore, sexual activity was improved in 60% of females with preoperative restrictions. LEVEL OF EVIDENCE IV.
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Zimmermann F, Börtlein J, Milinkovic DD, Balcarek P. Patient-Reported Outcomes After Revision Surgery for Failed Medial Patellofemoral Ligament Reconstruction: A Matched-Pair Analysis Including Correction of Predisposing Factors. Am J Sports Med 2020; 48:3566-3572. [PMID: 33104394 DOI: 10.1177/0363546520966354] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Complications and the need for revision surgery after medial patellofemoral ligament reconstruction (MPFLR) are evident in the current literature. However, there is a shortage of clinical data evaluating the results of revision surgery in individual patients after failed MPFLR. PURPOSE To investigate the results of tailored revision surgery for failed MPFLR, including the correction of predisposing factors. STUDY DESIGN Cohort study; Level of evidence, 3. METHODS Between August 2015 and March 2019, 25 patients (male:female, n = 9:16; mean ± SD age, 25.9 ± 6.5 years) underwent revision surgery for failed MPFLR (study group). The Banff Patella Instability Instrument 2.0 (BPII 2.0) and a numerical analog scale (0-10) for patellofemoral pain and subjective knee joint function were used to assess patient-reported quality of life before and after revision surgery. The control group of 50 patients (male:female, n = 18:32; age, 22.8 ± 4.3 years) who underwent identical patellar-stabilizing procedures was matched 1:2 by the surgical procedure, predisposing factors, sex, age, and follow-up time. RESULTS Evaluation was performed postoperatively at a mean 27.8 ± 14.0 months (range, 12-54 months) in the study group and 26.1 ± 11.2 months (range, 12-56 months) in the control group (P = .55). The BPII 2.0 score increased from 28.6 ± 17.9 points to 68.7 ± 22.3 points (P < .0001) in the study group and from 43.8 ± 22.5 points to 75.5 ± 21.4 points (P < .0001) in the control group from preoperatively to postoperatively, respectively. Before revision surgery, the BPII 2.0 scores in the study group were significantly inferior to those in the control group (P = .0026). At the final follow-up, the BPII 2.0 score in the study group was not significantly lower (P = .174), and a similar number of patients in the study group and the control group achieved the minimally clinically important difference (P = .49). Patellofemoral pain and subjective knee joint function improved significantly in both groups (P < .0001, P < .0001), without any significant difference between them at the final follow-up (P = .85, P = .86). CONCLUSION Revision surgery for MPFLR failure, including the correction of major anatomic risk factors, yielded a significant improvement in patient-reported quality-of-life outcome measures. Patients with failed MPFLR, however, were significantly more restricted before revision surgery than patients without previous interventions when evaluated with the BPII 2.0.
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Affiliation(s)
- Felix Zimmermann
- Arcus Sportklinik, Pforzheim, Germany.,BG Klinik Ludwigshafen, Ludwigshafen am Rhein, Germany
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18
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Hiemstra LA, Kerslake S, Lafave M. Letter to the editor. Knee Surg Sports Traumatol Arthrosc 2019; 27:3733-3734. [PMID: 31286165 DOI: 10.1007/s00167-019-05618-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 07/02/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Laurie Anne Hiemstra
- Banff Sport Medicine, PO Box 1300, Banff, AB, T1L 1B3, Canada. .,Department of Surgery, University of Calgary, Calgary, Canada.
| | - Sarah Kerslake
- Banff Sport Medicine, PO Box 1300, Banff, AB, T1L 1B3, Canada
| | - Mark Lafave
- Department of Physical Education and Recreation, Mount Royal University, Calgary, Canada
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Hiemstra LA, Page JL, Kerslake S. Patient-Reported Outcome Measures for Patellofemoral Instability: a Critical Review. Curr Rev Musculoskelet Med 2019; 12:124-137. [PMID: 30835079 PMCID: PMC6542883 DOI: 10.1007/s12178-019-09537-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
PURPOSE OF REVIEW The purpose of this paper was to review the current psychometric properties of patient-reported outcome measures that are commonly used for patients with patellofemoral instability. This review provides evidence to guide the selection of subjective outcome measures for assessing outcomes in clinical care and research studies. RECENT FINDINGS At the present time, there are two patient-reported outcome measures that have been designed for, and tested on, large cohorts of patellofemoral instability patients, the Banff Patella Instability Instrument (BPII) and the Norwich Patellar Instability Score (NPI). The BPII is a wholistic quality of life outcome measure and the NPI is a symptom score. The use of disease-specific outcome measures such as the BPII and NPI, in combination with generic knee, functional activity, and/or psychological outcome measures that have been proven to be valid and reliable for the patellofemoral instability population, is most likely to provide a well-rounded evaluation of treatment outcomes.
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Affiliation(s)
- Laurie Anne Hiemstra
- Banff Sport Medicine, PO Box 1300, Banff, Alberta, T1L 1B3, Canada.
- Department of Surgery, University of Calgary, Calgary, Canada.
| | - Jessica L Page
- Banff Sport Medicine, PO Box 1300, Banff, Alberta, T1L 1B3, Canada
| | - Sarah Kerslake
- Banff Sport Medicine, PO Box 1300, Banff, Alberta, T1L 1B3, Canada
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Becher C, Attal R, Balcarek P, Dirisamer F, Liebensteiner M, Pagenstert G, Schöttle P, Seitlinger G, Wagner D. Validierung der deutschsprachigen Version des Banff Patellofemorales Instabilitäts-Instrument 2.0. ARTHROSKOPIE 2018. [DOI: 10.1007/s00142-018-0191-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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