Enhancing Outcomes in Adolescent Patellofemoral Instability: The Case for Disease-Specific Instruments
Published: July 12, 2025
Read Time: 1 Minute
Recent research presented at the American Orthopaedic Society for Sports Medicine Annual Meeting in Nashville has illuminated the effectiveness of disease-specific patient-reported outcome (PRO) instruments. These tools, specifically aimed at assessing outcomes related to patellofemoral instability in adolescents, demonstrate a significant sensitivity to change compared to conventional region-specific assessment tools.
Key Insights
1. Disease-specific PRO instruments offer a heightened sensitivity to variations in patellofemoral instability.
2. They have been shown to mitigate the ceiling effect, which can limit patient outcome assessments.
Dr. Shital N. Parikh, a professor of orthopedic surgery at Cincinnati Children’s Hospital and the University of Cincinnati College of Medicine, remarked on his study’s findings, highlighting the suitability of the Banff Patellofemoral Instability Instrument (BPII 2.0). According to Parikh, moving forward, the BPII 2.0 should replace the traditional Kujala score as the preferred assessment tool for this condition.
In the study involving the Justifying Patellar Instability Treatment by Results (JUPITER) cohort, researchers evaluated postoperative PRO scores from 263 patients aged 19 years and younger, with a median age of 15 years (67.3% female). Each participant completed a suite of four PRO measures at baseline and again one year post-surgery, including the BPII 2.0, Kujala score, International Knee Documentation Committee (IKDC) score, and the Knee Injury and Osteoarthritis Outcome Score (KOOS).
The results underscored the BPII 2.0 as not only more sensitive to changes following surgery but also as the only instrument exempt from the ceiling effect. Parikh elaborated, stating, “A lack of ceiling effect allows for a broader range of scores, enabling precise differentiation among high-performing individuals or groups.”
He further emphasized the importance of utilizing disease-specific questionnaires over generalized instruments in clinical practice. In conditions targeting specific joints, tailored assessments yield more accurate evaluations of patient outcomes.
For further inquiries or details regarding this study, Dr. Shital N. Parikh can be reached via email at shital.parikh@cchmc.org.
Source:
Parikh SN, et al. “Instrument Performance in Assessing Patellofemoral Instability.” Presented at the American Orthopaedic Society for Sports Medicine Annual Meeting; July 10-13, 2025; Nashville, Tenn.
