The Norwich Patellar Instability Score: Validity, internal consistency and responsiveness for people conservatively-managed following first-time patellar dislocation

Smith, Toby; Chester, Rachel; Hunt, Nathan; Cross, Jane; Clark, Allan; Donell, Simon

doi:10.1016/j.knee.2015.10.003

Cited by 13 publications

(14 citation statements)

References 22 publications

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“…There are several more knee specific scores, but few are validated for children. 159,161,163 Preferable activity measures should be included in the evaluation; however, no specific activity score has been developed for children. Thus, often used in the age-mixed population is the Tegner activity score.…”

Section: Pro Measurementmentioning

confidence: 99%

Morphology and Anatomic Patellar Instability Risk Factors in First-Time Traumatic Lateral Patellar Dislocations: A Prospective Magnetic Resonance Imaging Study in Skeletally Immature Children

et al. 2016

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Section: Pro Measurementmentioning

confidence: 99%

Morphology and Anatomic Patellar Instability Risk Factors in First-Time Traumatic Lateral Patellar Dislocations: A Prospective Magnetic Resonance Imaging Study in Skeletally Immature Children

et al. 2016

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“…Despite the stated purpose, there is no exploration of the health state preference value (utility) of this type of outcome measure. In the setting of a complex patient population, the authors have not explained their rationale for using a generic QoL tool such as the EQ-5D-3L when there are disease-speciic patient-reported outcome measures available [14,18]. The EQ-5D-3L has previously demonstrated low sensitivity to small and medium health changes and low responsiveness to detect clinical change in patients with limb reconstruction [6,17].…”

mentioning

confidence: 99%

Letter to the editor

Hiemstra

Kerslake

Lafave

2019

Knee Surg Sports Traumatol Arthrosc

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Dear Professor Karlsson,We would appreciate the opportunity to comment on the article 'Isolated medial patellofemoral ligament reconstruction signiicantly improved quality of life in patients with recurrent patella dislocation' by Bouras et al. [3]. Overall, we are concerned with several aspects of the study design, the approach to the statistical analysis and particularly that some comments in the manuscript regarding outcome measures are misleading.The authors' statement that 'no study has speciically looked at quality of life (QoL)' following surgery for patellofemoral instability is not correct. There are numerous papers that have assessed QoL outcomes after MPFL reconstruction in large cohorts, some of which the authors have actually mentioned in this manuscript [1,4,[8][9][10][11][12][13][14][15][16]. These previous manuscripts all report improvement in QoL following patellar stabilisation using the Banf Patella Instability Instrument (BPII), the KOOS QoL subscale, or the SF-36.The increasing interest in patient-reported outcomes is important, and tools designed to assist researchers to assess the most appropriate measures such as the COnsensus-based Standards for health Measurement INstruments (COSMIN) should be employed. Details regarding the validity, reliability, responsiveness, and other psychometric properties of the Kujala scale and EQ-5D-3L outcome measures for the lateral patellofemoral instability (LPI) population are critical if the study conclusions are to have scientiic merit. Considering

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“…The Norwich Patellar Instability Score is a symptom score developed in 2014 [31]. While its use in the literature is limited thus far, its responsiveness is to comparable to the Lysholm score, and it has the advantage of being specifically validated in first‐time dislocators [29] and without ceiling effects [30].…”

Section: Discussionmentioning

confidence: 99%

Patient-reported outcome scores following patellar instability surgery-high prevalence does not equal high responsiveness: a systematic review

Magnuson

Platt

Zacharias

et al. 2021

Knee Surg Sports Traumatol Arthrosc

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Purpose The purpose of this study was to determine the utilization and responsiveness of common patient-reported outcomes (PROs) in patients undergoing surgery for patellar instability. Methods Using PRISMA guidelines, a systematic review of studies reporting outcomes following surgical intervention for patellar instability was conducted using Pubmed, Cochrane, OVID Medline, and Google Scholar. Subgroup analysis of articles reporting at least two PROs with baseline and follow-up data were used to evaluate responsiveness of instruments using relative eiciency and efect size. Results From the search, 2,848 unique articles were found, of which 178 were included in inal analysis (7,122 patients, mean age 22.6, 63.6% female). The most commonly used PRO was the Kujala score (79.2%), followed by the Lysholm (34.8%), and Tegner (30.9%). Seventy-nine articles were eligible for subgroup analysis. The Kujala had a higher relative eiciency than ten of the 14 instruments to which it was compared but had lower relative eiciency compared to the IKDC and Lysholm scores. The Banf Patella Instability Instrument (BPII) and the Norwich score, condition-speciic tools, were unable to be fully assessed due to rarity of use and lack of comparisons. ConclusionThe hypothesis that the Kujala score is the most commonly used PRO for patellar instability, although other instruments ofer greater eiciency was supported by our results. The IKDC and Lysholm scores had similar efect sizes but higher relative eiciencies than the Kujala, thus suggesting better responsiveness. This analysis adds useful information for surgeons on the efectiveness of the most common PRO's for evaluating patellofemoral instability outcomes. Level of evidence Level III.

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The Norwich Patellar Instability Score: Validity, internal consistency and responsiveness for people conservatively-managed following first-time patellar dislocation

Cited by 13 publications

References 22 publications

Morphology and Anatomic Patellar Instability Risk Factors in First-Time Traumatic Lateral Patellar Dislocations: A Prospective Magnetic Resonance Imaging Study in Skeletally Immature Children

Morphology and Anatomic Patellar Instability Risk Factors in First-Time Traumatic Lateral Patellar Dislocations: A Prospective Magnetic Resonance Imaging Study in Skeletally Immature Children

Letter to the editor

Patient-reported outcome scores following patellar instability surgery-high prevalence does not equal high responsiveness: a systematic review

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