{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T16:39:02Z","timestamp":1793723942931,"version":"4.6.1"},"reference-count":35,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2013,1,11]],"date-time":"2013-01-11T00:00:00Z","timestamp":1357862400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2014,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>No outcome measurements have previously been designed to assess patient\u2010perceived patellar instability. The purposes of this study were to address this limitation and to describe the development and validation of the Norwich Patellar Instability (NPI) scores, a self\u2010administered 19\u2010item questionnaire to assess perceived patellar instability.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A previous study assessed activities that aggravated symptoms in individuals with patellar dislocation and instability symptoms. These reported activities were ranked in order of severity, and a weighting system was calculated. The NPI score was introduced to routine clinical practice in three institutions. One hundred and two people who had experienced a lateral patellar dislocation completed 102\u00a0NPI questionnaires. The completed NPI score was correlated with the Knee injury and Osteoarthritis Outcome Score (KOOS) to evaluate divergent validity and with the J\u2010sign, patellar mobility, apprehension test, Beighton score, Kujala Patellofemoral Disorder Score and Lysholm Knee Score to evaluate convergent validity. Internal consistency of the 19 items was also calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The results indicated a moderate correlation between the NPI score and the Kujala Patellofemoral Disorder Score (rho = \u22120.66; <jats:italic>p<\/jats:italic> &lt; 0.01) and Lysholm Knee Score (rho = \u22120.54; <jats:italic>p<\/jats:italic> = 0.03), suggesting good convergent validity. There was a little correlation between the KOOS and NPI score, indicating divergent validity (rho = \u22120.02 to \u22120.17; n.s.). There was high internal consistency (Cronbach's alpha = 0.93).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>These results indicate the NPI score to be a valid tool to assess patellar instability for individuals following patellar dislocation. Further study is now required in order to assess the reliability and responsiveness of this new outcome measure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>III.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-012-2359-x","type":"journal-article","created":{"date-parts":[[2013,1,9]],"date-time":"2013-01-09T22:51:23Z","timestamp":1357771883000},"page":"324-335","source":"Crossref","is-referenced-by-count":71,"title":["The development, validation and internal consistency of the Norwich Patellar Instability (NPI) score"],"prefix":"10.1002","volume":"22","author":[{"given":"Toby O.","family":"Smith","sequence":"first","affiliation":[{"name":"Queen's Building Faculty of Medicine and Health Sciences University of East Anglia Norwich Research Park NR4 7TJ Norwich UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon T.","family":"Donell","sequence":"additional","affiliation":[{"name":"Queen's Building Faculty of Medicine and Health Sciences University of East Anglia Norwich Research Park NR4 7TJ Norwich UK"},{"name":"Norfolk and Norwich University Hospital Norwich UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allan","family":"Clark","sequence":"additional","affiliation":[{"name":"Queen's Building Faculty of Medicine and Health Sciences University of East Anglia Norwich Research Park NR4 7TJ Norwich UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Chester","sequence":"additional","affiliation":[{"name":"Queen's Building Faculty of Medicine and Health Sciences University of East Anglia Norwich Research Park NR4 7TJ Norwich UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Cross","sequence":"additional","affiliation":[{"name":"Queen's Building Faculty of Medicine and Health Sciences University of East Anglia Norwich Research Park NR4 7TJ Norwich UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deiary F.","family":"Kader","sequence":"additional","affiliation":[{"name":"Queen Elizabeth Hospital Gateshead UK"},{"name":"Northumbria University Newcastle upon Tyne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth A.","family":"Arendt","sequence":"additional","affiliation":[{"name":"University of Minnesota Minneapolis MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,1,11]]},"reference":[{"key":"e_1_2_7_2_1","volume-title":"Surgery of the knee","author":"Aglietti P","year":"2001"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/03635465000280040601"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.51B3.444"},{"key":"e_1_2_7_5_1","volume-title":"An Introduction to medial statistics","author":"Bland M","year":"2006"},{"key":"e_1_2_7_6_1","volume-title":"Clinical sports medicine","author":"Brukner P","year":"2003"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/036354658801600308"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/jor.20790"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cuor.2006.02.016"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0030-1247149"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546503260788"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-199072090-00027"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200011000-00019"},{"key":"e_1_2_7_14_1","first-page":"92","article-title":"Patellofemoral semantics. 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