Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 27, Issue 11, pp 3735–3737 | Cite as

Isolated medial patellofemoral ligament reconstruction significantly improved quality of life in patients with recurrent patella dislocation: a response to Hiemstra et al.’s letter to the editor

  • Theodoros BourasEmail author
  • Jan Herman Kuiper
  • Andrew Barnett

Dear Professor Karlsson,

Thank you very much for your recent correspondence and in particular the letter from Hiemstra et al. [5]. We thank them for their careful reading of our publication and gladly use this opportunity to address the issues they raise.

We acknowledge that they have undertaken a significant amount of research work in this field, having first published the Banff Patellar Instability Instrument (BPII) in 2013. It was certainly not our intention to undermine the BPII in any way. Our aim was to report general health related and not condition specific Quality of Life (QoL) outcome for our patients, in addition to health-economic outcomes, using the EQ-5D questionnaire. We apologise if this was not easily understood when reading our paper.

The statement “no study has specifically looked at quality of life (QoL)” is indeed incorrect, as pointed out by Hiemstra et al. [5]. However, our full statement in the paper reads “no study has specifically looked at quality of life...



  1. 1.
    Cameron AC, Trivedi PK (2005) Microeconometrics: methods and applications. Cambridge University Press, Cambridge. ISBN 9780521848053Google Scholar
  2. 2.
    European Medicine Agency (2010) Guideline in confirmatory clinical trials. CPMP/EWP/1776/99 Rev. 1Google Scholar
  3. 3.
    Fältström A, Hägglund M, Kvist J (2013) Patient-reported knee function, quality of life, and activity level after bilateral anterior cruciate ligament injuries. Am J Sports Med 41(12):2805–2813CrossRefPubMedGoogle Scholar
  4. 4.
    Goodwin E, Green C (2016) A systematic review of the literature on the development of condition-specific preference-based measures of health. Appl Health Econ Health Policy 14(2):161–183CrossRefPubMedGoogle Scholar
  5. 5.
    Hiemstra LA, Kerslake S, Lafave M (2019) Letter to the editor. Knee Surg Sports Traumatol Arthrosc. CrossRefPubMedGoogle Scholar
  6. 6.
    Hiemstra LA, Kerslake S, Lafave M, Mohtadi NG (2016) Concurrent validation of the banff patella instability instrument to the norwich patellar instability score and the kujala score in patients with patellofemoral instability. Orthop J Sports Med 4(5):2325967116646085CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Hunger M, Döring A, Holle R (2012) Longitudinal beta regression models for analyzing health-related quality of life scores over time. BMC Med Res Methodol 12(1):144CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Longworth L, Yang Y, Young T, Mulhern B, Hernández Alava M, Mukuria C, Brazier J (2014) Use of generic and condition-specific measures of health-related quality of life in NICE decision-making: a systematic review, statistical modelling and survey. Health Technol Assess 18(9):1–224CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Oak SR, Strnad GJ, Bena J, Farrow LD, Parker RD, Jones MH, Spindler KP (2016) Responsiveness comparison of the EQ-5D, PROMIS global health, and VR-12 questionnaires in knee arthroscopy. Orthop J Sports Med 4(12):2325967116674714CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Payakachat N, Ali MM, Tilford JM (2015) Can the EQ-5D detect meaningful change? A systematic review. PharmacoEconomics 33(11):1137–1154CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Pinheiro JC, Bates DM (2000) Mixed-effects models in s and S-PLUS. Springer, New York. Scholar
  12. 12.
    Saarni SI, Härkänen T, Sintonen H, Suvisaari J, Koskinen S, Aromaa A, Lönnqvist J (2006) The impact of 29 chronic conditions on health-related quality of life: a general population survey in Finland using 15D and EQ-5D. Qual Life Res 15(8):1403–1414CrossRefPubMedGoogle Scholar
  13. 13.
    Versteegh MM, Leunis A, Uyl-de Groot CA, Stolk EA (2012) Condition-specific preference-based measures: benefit or burden? Value Health Reg Issues 15(3):504–513CrossRefGoogle Scholar
  14. 14.
    Wu M, Brazier JE, Kearns B, Relton C, Smith C, Cooper L (2015) Examining the impact of long-standing health conditions on health-related quality of life using the EQ-5D in a general population sample. Eur J Health Econ 16(2):141–151CrossRefPubMedGoogle Scholar
  15. 15.
    Zaffagnini S, Grassi A, Marcheggiani Muccioli GM, Luetzow WF, Vaccari V, Benzi A, Marcacci M (2014) Medial patellotibial ligament (MPTL) reconstruction for patellar instability. Knee Surg Sports Traumatol Arthrosc 22(10):2491–2498CrossRefPubMedGoogle Scholar

Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2019

Authors and Affiliations

  1. 1.Sports Knee DepartmentThe Robert Jones and Agnes Hunt Orthopaedic HospitalOswestryUK
  2. 2.School of Pharmacy and BioengineeringKeele UniversityKeeleUK

Personalised recommendations