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Age- and sex-specific reference values for the Banff Patella Instability Instrument (BPII 2.0) in the German
Felix Zimmermann1,2, Peter Balcarek1,3, Johannes Maria Giesinger4
1ARCUS Sportklinik, Orthopedics and Traumatology, Pforzheim, Germany.
Purpose:
The Banff Patella Instability Instrument (BPII 2.0) is a validated patient-reported outcome measure to assess disease-specific quality of life in individuals with lateral patellar instability. This study aimed to establish age- and sex-specific reference values for the German general population and to identify participant-specific factors influencing BPII 2.0 scores.
Methods:
Data were collected using quota sampling from 1309 participants via an online panel. The sample was stratified into 12 subgroups (n ≥ 100 per subgroup) based on age and sex and weighted to align with German census data. Demographic and health-related data were collected; descriptive statistics and percentiles were used to report age- and sex specific reference values. An analysis of variance (ANOVA) model was built to examine the influence of body mass index (BMI) and comorbidities on BPII 2.0 scores.
Results:
Males showed higher BPII 2.0 scores compared to females (75.1 ± 24.0 points vs. 71.0 ± 26.8 points; p < 0.01). Participants aged 14-30 years showed significantly higher mean scores (79.6 ± 20.5 points) than those participants >30 years (71.2 ± 26.4 points) (p < 0.01). ANOVA displayed significant (p < 0.001) decreasing mean scores with an increase in BMI categories (76.0 points; CI 73.9-78.0 points in under/normal weight compared to 64.3 points; CI 60.2-68.3 points in participants with obesity II + III). Participants with self-reported comorbidities showed significantly (p < 0.001) lower mean scores (60.0 points; CI 57.9-62.1 points) compared to persons without comorbidities (82.9 points; CI 80.6-85.2 points). The regression analysis further showed decreasing BPII 2.0 scores with increasing age (-0.24 points per life year).
Conclusion:
This study provides the first age- and sex-stratified reference BPII 2.0 values for the German population. Higher age, female sex, the presence of comorbidities and a higher BMI have a significant negative impact on reference values for the BPII 2.0.
Level Of Evidence:
Level IV.
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