Expanding role of VISA-P in patellofemoral pain assessment-case for caution and context

The VISA-P originally developed to assess patellar tendinopathy severity, is increasingly being applied to patellofemoral pain (PFP) assessment. This editorial examines the expanding role of VISA-P within the context of existing patient-reported outcome measures (PROMs) for PFP, such as the Kujala Anterior Knee Pain Scale and the Knee injury and Osteoarthritis Outcome Score for Patellofemoral Pain and Osteoarthritis. While VISA-P offers advantages in brevity, readability, and temporal stability, its original design targeting athletic populations with patellar tendinopathy limits its specificity and comparability when applied broadly to heterogeneous PFP populations. Moreover, VISA-P currently lacks validated diagnostic thresholds to guide clinical decision-making. Although the recent validation of VISA-P in Spanish-speaking populations enhances accessibility, caution is advised in its widespread adoption without clear delineation of its role relative to other PROMs. The editorial argues for careful contextual use of VISA-P, emphasizing the need for tools that balance specificity, efficiency, and universality to capture the complex spectrum of PFP across diverse populations.