Evidence map›Paper›PMID 40910363›Full record

ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2026

Estimation of the patient acceptable symptom state (PASS) threshold for the Banff Patellofemoral Instability Instrument 2.0.

Per Arne Skarstein Waaler, Eivind Inderhaug, Thomas Birkenes, Asle Birkeland Kjellsen, Trine Hysing-Dahl

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Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Per Arne Skarstein WaalerDepartment of Orthopaedic Surgery, Haukeland University Hospital, Bergen, Norway.ORCID https://orcid.org/0000-0002-2132-3365
Eivind InderhaugDepartment of Orthopaedic Surgery, Haukeland University Hospital, Bergen, Norway.ORCID https://orcid.org/0000-0001-7959-163X
Thomas BirkenesDepartment of Orthopaedic Surgery, Haukeland University Hospital, Bergen, Norway.ORCID https://orcid.org/0000-0003-1583-5740
Asle Birkeland KjellsenDepartment of Orthopaedic Surgery, Haukeland University Hospital, Bergen, Norway.
Trine Hysing-DahlDepartment of Clinical Medicine, Sports Traumatology and Arthroscopy Research Group (STAR Group), University of Bergen, Bergen, Norway.ORCID https://orcid.org/0000-0003-3342-681X

Funding

The Norwegian Knee Ligament Register, Department of Orthopedic Surgery, Haukeland University Hospital, Bergen, Norway
6 · The paper itself

Abstract

purposeThere is a paucity of studies reporting patient acceptable symptom state (PASS) thresholds for patient reported outcome measures validated for patellar instability. The aim of this study was to determine the PASS threshold for the Banff Patellofemoral Instability Instrument 2.0 (BPII) following surgery for recurrent patellar instability.

methodsPatients who underwent patellar stabilisation surgery between 2013 and 2022 were included if they were ≥16 years of age and had ≥12 months of follow-up. The participants completed the BPII and a dichotomous PASS anchor question. The PASS threshold was then calculated using both the adjusted predictive modelling method and receiver operating characteristic (ROC) analysis.

resultsComplete data were available for 218 knees of 182 patients, with a median follow-up time of 46 months. The PASS threshold was 62.4 (95% confidence interval [CI]: 58.8-65.9) using the adjusted predictive modelling method, and 66.3 (95% CI: 58.1-80.0) using ROC analysis. Overall, 173 patients (79.4%) reported satisfactory symptom states, while 72.9% and 70.6% achieved the respective PASS thresholds. The adjusted predictive modelling method yielded narrower 95% confidence intervals with minimal threshold variation across different approaches for handling bilateral cases compared to ROC analysis (1.3 vs. 8.1 points).

conclusionThe PASS threshold for BPII after patellar stabilisation surgery was 62.4 (out of 100 points). The adjusted predictive modelling method demonstrated superior precision and robustness in the PASS threshold calculation compared with the ROC analysis. This threshold provides a disease-specific reference for clinical decision making and research in patellofemoral instability. LEVEL OF EVIDENCE: Level III.

Indexed as

Joint InstabilityPatellar DislocationPatellofemoral JointPatient Reported Outcome MeasuresAdolescentAdultFemaleHumansMaleRecurrenceROC CurveYoung AdultBanff Patellofemoral Instability Instrument (BPII)patellar dislocationspatellar instabilitypatient acceptable symptom state (PASS)patient reported outcome measure (PROM)

Identifiers

PMID40910363
PMCPMC13418289

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