doi: 10.1016/j.knee.2025.06.015.
Online ahead of print.
Evaluation of practice patellofemoral instability collaborative (EPPIC)
Collaborators,
Affiliations
Collaborators
-
BASK Trainee Collaborative:
Jon Kosy 1 , William Thomas 1 , Ryan Higgin 1 , Joanna Thomas 2 , Abdulrahman Odeh 2 , James Archer 2 , Christopher Edward Bache 2 , Andrew Gaffey 2 , Pranai Buddhdev 3 , Hilary Bosman 3 , Albert Wee Tun Ngu 3 , Thomas Stringfellow 3 , Moritz Lebe 3 , Sunny Parikh 3 , Ahmed Sanalla 3 , Wasmin Khan 4 , Maria Tennyson 4 , Simon Hislop 4 , Jonathon Lenihan 4 , Mohammed Abdalla Ahmed Almustafa 4 , Dinnish Baskaran 4 , Kendrick To 4 , William Hughes 4 , Mohammad Mustafa Butt 4 , Ram Venkatesh 5 , Lara Dawood 5 , Danielle Archer 5 , Ammer Jamjoom 5 , Gautam Reddy 5 , Sanjeev Anand 5 , Vishal Rajput 5 , Hawar Akrawi 5 , Mark Loeffler 6 , Ahmad Al-Sukaini 6 , Ashok Ramasamy 6 , Shoaib Syed 6 , Muddassir Khan 6 , Raghuram Thonse 7 , Arjun Paramasivan 7 , Robert Morton 7 , Aatif Mahmood 7 , Weisang Luo 7 , Hafiz Muhammad Umer 7 , Paul Haslam 8 , Graeme Hancock 8 , Chris Servant 9 , James Gill 9 , Tim Karssiens 9 , Ryan Wood 9 , Mark Bowditch 9 , Hersh Deo 10 , Jennifer Barwell 10 , George Hourston 10 , Dylan Wyatt 10 , Alvin Chen 11 , John Williams 11 , Manjunathan Sivaprakasam 11 , James Young 12 , Murtaza Khwaja 12 , Stefan Sleiman 12 , Nicholas Bowman 12 , Richard J Napier 13 , Graham Finlayson 13 , Kenneth Jones 13 , Mark J Blyth 14 , Graeme P Hopper 14 , Ben Wheelwright 14 , Stephen Dalgleish 15 , Peter S E Davies 15 , Robert J H Sinnerton 15 , Carina Bänziger 15 , Athena Abell 15 , Iain McNamara 16 , Raashad Hasan 16 , Ignatius Liew 17 , Maheswaran Archunan 16 , Daniel Watts 16 , Sadhin Subhash 16 , Oliver Negus 16 , Scott Muller 18 , Stuart Irvine 18 , Nicholas Bottomley 19 , Alex Woods 19 , Chris Bretherton 19 , Richard Myatt 19 , Claudia Paul 19 , Hamez Gacaferi 19 , Jon Smith 20 , James Newman 20 , Andrew Cohen 20 , James Cruickshank 20 , Rashid Kahn 21 , George Matheron 21 , Jaison Patel 21 , Emily Crane 21 , Richard Roach 22 , Rakan Kabariti 22 , Tahir Khaleeq 22 , Jeremy Rushbrook 23 , Zeid Morcos 23 , Gajendiran Thiruchandran 23 , Joe Barrett-Lee 23 , Lucy Bailey 23 , Sivaraman Subramanian 24 , John Britton 24 , Alistair Tindall 25 , Kamalpreet Cheema 25 , Jennifer Oluku 25 , Alex Saleh 25 , Jacinder Chahal 25 , Andre Fernandes 25 , Dimitrios Papadopoulus 25 , Spilious Dellis 25 , Karmen El-Raheb 25 , Adebola Akintade 25 , Georgios Saraglis 25 , Sarah Mitchell 26 , Jun Min Leow 26 , Vipul Mandalia 27 , Edward Skinner 27 , Simon Middleton 27 , Peter Schranz 27 , Gordon Gillespie 28 , Joshua Howard 28 , Tim White 29 , Navnit Makaram 29 , Cameron Simpson 29 , Phoebe Johnstone 29 , Kash Akhtar 30 , Edward Karam 30 , David Ferguson 30 , Rory Cuthbert 30 , Lilanthi Wickramarachchi 30 , Kaifeng Liang 30 , Aqeel Bhutta 31 , Tom Havenhand 31 , Lee Hoggett 31 , Gareth Rogers 31 , Christopher Waugh 31 , Jonathan Cowie 31 , Tanweer Ashraf 32 , Tamer Sweed 32 , Mohammed Mussa 32 , Huan Dong 32 , Yasir Ashraf 32 , James Stoddard 33 , Raveen Jayasuriya 33 , Harvey George 33 , Jonathan Craik 34 , Liam Rose 34 , Ran Wei 34 , Damian Clark 35 , Richard Donovan 35 , Sarah Shiels 35 , Thomas Tilston 35 , David Johnson 36 , Thomas Baigent 36 , Karim Iqbal 36 , Ejaz Mughal 37 , Varun Dewan 38 , Govind Chauhan 37 , Awais Habeebullah 37 , Sabri Bleibleh 37 , Jasprit Kaur 37 , Prabhu Thanikachalam 37 , Andy Metcalfe 39 , Wayne Ng Weiyun 39 , Harry Krishnan 39 , Jonathan Eldridge 40 , Oliver Beaumont 40 , Philip Chapman Sheath 41 , Adam Stoneham 41 , William Morley 41 , Catherine Gibson 41 , Hossam Fraig 41 , Dan Bowen 41 , Fahad Hossain 42 , Hartej Sur 42 , Sonam Sherbaz 42 , Khabab Osman 42 , Nikhil Khadabadi 42 , Aasim Saleemi 42 , Muhammad Arif 42 , Thomas Moores 42 , Paul Nicolai 43 , Jason Sibbel 43 , Will Nabulyato 43 , Aly Pathan 43 , Ciaran Mcgarvey 44 , Marriam Ahmed 44 , Kartik Logishetty 44 , Khalid Al-Hourani 45 , Morgan Baileyi 46 , Caroline Hingi 47
Affiliations
- 1 Basingstoke and North Hampshire NHS Foundation Trust, Basingstoke, UK.
- 2 Birmingham Children's Hospital, Birmingham, UK.
- 3 Broomfield Hospital, Chelmsford, UK.
- 4 Cambridge University Hospitals, Cambridge, UK.
- 5 Chapel Allerton Hospital, Leeds, UK.
- 6 Colchester Hospital, Colchester, UK.
- 7 Countess of Chester Hospital, Chester, UK.
- 8 Doncaster Royal Infirmary, Doncaster, UK.
- 9 Ipswich Hospital, Ipswich, UK.
- 10 James Paget University Hospitals, Great Yarmouth, UK.
- 11 King's College Hospital, London, UK.
- 12 Maidstone & Tunbridge Wells Hospitals, Kent, UK.
- 13 Musgrave Park Hospital, Belfast, UK.
- 14 NHS Greater Glasgow and Clyde, Glasgow, UK.
- 15 NHS Tayside, UK.
- 16 Norfolk and Norwich University Hospital, Norwich, UK.
- 17 Norfolk and Norwich University Hospital, Norwich, UK; Queen Elizabeth Hospital King's Lynn, King's Lynn, UK.
- 18 Northumbria Healthcare Foundation Trust, UK.
- 19 Oxford University Hospitals, Oxford, UK.
- 20 Pinderfield General Hospital/Dewsbury and District Hospital, UK.
- 21 Princess Alexandra Hospital, Harlow, UK.
- 22 Princess Royal Hospital, Telford, UK.
- 23 Queen Alexandra Hospital, Portsmouth, UK.
- 24 Queen Elizabeth Hospital King's Lynn, King's Lynn, UK.
- 25 Queen Elizabeth Hospital Woolwich, London, UK.
- 26 Queen Margaret Hospital/Victoria Hospital, NHS Fife, UK.
- 27 Royal Devon and Exeter Hospital, Exeter, UK.
- 28 Royal Gwent Hospital, Newport, UK.
- 29 Royal Infirmary of Edinburgh, Edinburgh, UK.
- 30 Royal London Hospital, London, UK.
- 31 Royal Oldham Hospital, Oldham, UK.
- 32 Royal Orthopaedic Hospital, Birmingham, UK.
- 33 Sheffield Teaching Hospital, Sheffield, UK.
- 34 South West London Elective Orthopaedic Centre, Epsom, UK.
- 35 Southmead Hospital, Bristol, UK.
- 36 Stepping Hill Hospital, Stockport, UK.
- 37 The Royal Wolverhampton NHS Trust, Wolverhampton, UK.
- 38 The Royal Wolverhampton NHS Trust, Wolverhampton, UK. Electronic address: Varun.dewan@nhs.net.
- 39 University Hospital Coventry & Warwickshire, Coventry, UK.
- 40 University Hospitals Bristol, Bristol, UK.
- 41 University Hospitals Southampton, Southampton, UK.
- 42 Walsall Manor Hospital, Walsall, UK.
- 43 West Suffolk Hospital, Suffolk, UK.
- 44 Wexham Park Hospital, Slough, UK.
- 45 Frimey Health NHS Foundation Trust, UK.
- 46 University Hospital Southampton NHS Foundation Trust, UK.
- 47 St George's University Hospital NHS Foundation Trust, UK.
- PMID: 41046809
- DOI: 10.1016/j.knee.2025.06.015
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Evaluation of practice patellofemoral instability collaborative (EPPIC)
BASK Trainee Collaborative.
Knee.
.
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Format
doi: 10.1016/j.knee.2025.06.015.
Online ahead of print.
Author
Collaborators
-
BASK Trainee Collaborative:
Jon Kosy 1 , William Thomas 1 , Ryan Higgin 1 , Joanna Thomas 2 , Abdulrahman Odeh 2 , James Archer 2 , Christopher Edward Bache 2 , Andrew Gaffey 2 , Pranai Buddhdev 3 , Hilary Bosman 3 , Albert Wee Tun Ngu 3 , Thomas Stringfellow 3 , Moritz Lebe 3 , Sunny Parikh 3 , Ahmed Sanalla 3 , Wasmin Khan 4 , Maria Tennyson 4 , Simon Hislop 4 , Jonathon Lenihan 4 , Mohammed Abdalla Ahmed Almustafa 4 , Dinnish Baskaran 4 , Kendrick To 4 , William Hughes 4 , Mohammad Mustafa Butt 4 , Ram Venkatesh 5 , Lara Dawood 5 , Danielle Archer 5 , Ammer Jamjoom 5 , Gautam Reddy 5 , Sanjeev Anand 5 , Vishal Rajput 5 , Hawar Akrawi 5 , Mark Loeffler 6 , Ahmad Al-Sukaini 6 , Ashok Ramasamy 6 , Shoaib Syed 6 , Muddassir Khan 6 , Raghuram Thonse 7 , Arjun Paramasivan 7 , Robert Morton 7 , Aatif Mahmood 7 , Weisang Luo 7 , Hafiz Muhammad Umer 7 , Paul Haslam 8 , Graeme Hancock 8 , Chris Servant 9 , James Gill 9 , Tim Karssiens 9 , Ryan Wood 9 , Mark Bowditch 9 , Hersh Deo 10 , Jennifer Barwell 10 , George Hourston 10 , Dylan Wyatt 10 , Alvin Chen 11 , John Williams 11 , Manjunathan Sivaprakasam 11 , James Young 12 , Murtaza Khwaja 12 , Stefan Sleiman 12 , Nicholas Bowman 12 , Richard J Napier 13 , Graham Finlayson 13 , Kenneth Jones 13 , Mark J Blyth 14 , Graeme P Hopper 14 , Ben Wheelwright 14 , Stephen Dalgleish 15 , Peter S E Davies 15 , Robert J H Sinnerton 15 , Carina Bänziger 15 , Athena Abell 15 , Iain McNamara 16 , Raashad Hasan 16 , Ignatius Liew 17 , Maheswaran Archunan 16 , Daniel Watts 16 , Sadhin Subhash 16 , Oliver Negus 16 , Scott Muller 18 , Stuart Irvine 18 , Nicholas Bottomley 19 , Alex Woods 19 , Chris Bretherton 19 , Richard Myatt 19 , Claudia Paul 19 , Hamez Gacaferi 19 , Jon Smith 20 , James Newman 20 , Andrew Cohen 20 , James Cruickshank 20 , Rashid Kahn 21 , George Matheron 21 , Jaison Patel 21 , Emily Crane 21 , Richard Roach 22 , Rakan Kabariti 22 , Tahir Khaleeq 22 , Jeremy Rushbrook 23 , Zeid Morcos 23 , Gajendiran Thiruchandran 23 , Joe Barrett-Lee 23 , Lucy Bailey 23 , Sivaraman Subramanian 24 , John Britton 24 , Alistair Tindall 25 , Kamalpreet Cheema 25 , Jennifer Oluku 25 , Alex Saleh 25 , Jacinder Chahal 25 , Andre Fernandes 25 , Dimitrios Papadopoulus 25 , Spilious Dellis 25 , Karmen El-Raheb 25 , Adebola Akintade 25 , Georgios Saraglis 25 , Sarah Mitchell 26 , Jun Min Leow 26 , Vipul Mandalia 27 , Edward Skinner 27 , Simon Middleton 27 , Peter Schranz 27 , Gordon Gillespie 28 , Joshua Howard 28 , Tim White 29 , Navnit Makaram 29 , Cameron Simpson 29 , Phoebe Johnstone 29 , Kash Akhtar 30 , Edward Karam 30 , David Ferguson 30 , Rory Cuthbert 30 , Lilanthi Wickramarachchi 30 , Kaifeng Liang 30 , Aqeel Bhutta 31 , Tom Havenhand 31 , Lee Hoggett 31 , Gareth Rogers 31 , Christopher Waugh 31 , Jonathan Cowie 31 , Tanweer Ashraf 32 , Tamer Sweed 32 , Mohammed Mussa 32 , Huan Dong 32 , Yasir Ashraf 32 , James Stoddard 33 , Raveen Jayasuriya 33 , Harvey George 33 , Jonathan Craik 34 , Liam Rose 34 , Ran Wei 34 , Damian Clark 35 , Richard Donovan 35 , Sarah Shiels 35 , Thomas Tilston 35 , David Johnson 36 , Thomas Baigent 36 , Karim Iqbal 36 , Ejaz Mughal 37 , Varun Dewan 38 , Govind Chauhan 37 , Awais Habeebullah 37 , Sabri Bleibleh 37 , Jasprit Kaur 37 , Prabhu Thanikachalam 37 , Andy Metcalfe 39 , Wayne Ng Weiyun 39 , Harry Krishnan 39 , Jonathan Eldridge 40 , Oliver Beaumont 40 , Philip Chapman Sheath 41 , Adam Stoneham 41 , William Morley 41 , Catherine Gibson 41 , Hossam Fraig 41 , Dan Bowen 41 , Fahad Hossain 42 , Hartej Sur 42 , Sonam Sherbaz 42 , Khabab Osman 42 , Nikhil Khadabadi 42 , Aasim Saleemi 42 , Muhammad Arif 42 , Thomas Moores 42 , Paul Nicolai 43 , Jason Sibbel 43 , Will Nabulyato 43 , Aly Pathan 43 , Ciaran Mcgarvey 44 , Marriam Ahmed 44 , Kartik Logishetty 44 , Khalid Al-Hourani 45 , Morgan Baileyi 46 , Caroline Hingi 47
Affiliations
- 1 Basingstoke and North Hampshire NHS Foundation Trust, Basingstoke, UK.
- 2 Birmingham Children's Hospital, Birmingham, UK.
- 3 Broomfield Hospital, Chelmsford, UK.
- 4 Cambridge University Hospitals, Cambridge, UK.
- 5 Chapel Allerton Hospital, Leeds, UK.
- 6 Colchester Hospital, Colchester, UK.
- 7 Countess of Chester Hospital, Chester, UK.
- 8 Doncaster Royal Infirmary, Doncaster, UK.
- 9 Ipswich Hospital, Ipswich, UK.
- 10 James Paget University Hospitals, Great Yarmouth, UK.
- 11 King's College Hospital, London, UK.
- 12 Maidstone & Tunbridge Wells Hospitals, Kent, UK.
- 13 Musgrave Park Hospital, Belfast, UK.
- 14 NHS Greater Glasgow and Clyde, Glasgow, UK.
- 15 NHS Tayside, UK.
- 16 Norfolk and Norwich University Hospital, Norwich, UK.
- 17 Norfolk and Norwich University Hospital, Norwich, UK; Queen Elizabeth Hospital King's Lynn, King's Lynn, UK.
- 18 Northumbria Healthcare Foundation Trust, UK.
- 19 Oxford University Hospitals, Oxford, UK.
- 20 Pinderfield General Hospital/Dewsbury and District Hospital, UK.
- 21 Princess Alexandra Hospital, Harlow, UK.
- 22 Princess Royal Hospital, Telford, UK.
- 23 Queen Alexandra Hospital, Portsmouth, UK.
- 24 Queen Elizabeth Hospital King's Lynn, King's Lynn, UK.
- 25 Queen Elizabeth Hospital Woolwich, London, UK.
- 26 Queen Margaret Hospital/Victoria Hospital, NHS Fife, UK.
- 27 Royal Devon and Exeter Hospital, Exeter, UK.
- 28 Royal Gwent Hospital, Newport, UK.
- 29 Royal Infirmary of Edinburgh, Edinburgh, UK.
- 30 Royal London Hospital, London, UK.
- 31 Royal Oldham Hospital, Oldham, UK.
- 32 Royal Orthopaedic Hospital, Birmingham, UK.
- 33 Sheffield Teaching Hospital, Sheffield, UK.
- 34 South West London Elective Orthopaedic Centre, Epsom, UK.
- 35 Southmead Hospital, Bristol, UK.
- 36 Stepping Hill Hospital, Stockport, UK.
- 37 The Royal Wolverhampton NHS Trust, Wolverhampton, UK.
- 38 The Royal Wolverhampton NHS Trust, Wolverhampton, UK. Electronic address: Varun.dewan@nhs.net.
- 39 University Hospital Coventry & Warwickshire, Coventry, UK.
- 40 University Hospitals Bristol, Bristol, UK.
- 41 University Hospitals Southampton, Southampton, UK.
- 42 Walsall Manor Hospital, Walsall, UK.
- 43 West Suffolk Hospital, Suffolk, UK.
- 44 Wexham Park Hospital, Slough, UK.
- 45 Frimey Health NHS Foundation Trust, UK.
- 46 University Hospital Southampton NHS Foundation Trust, UK.
- 47 St George's University Hospital NHS Foundation Trust, UK.
- PMID: 41046809
- DOI: 10.1016/j.knee.2025.06.015
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Abstract
Background: The management of patellofemoral instability in the United Kingdom remains poorly standardised. Through the British Association for Surgery of the Knee trainee collaborative, we aimed to identify which procedures (and in which combination) were being used to surgically manage this common condition across the UK.
Method: A retrospective national audit was conducted via a trainee collaborative analysing local trust data between 1st January 2014 and 31st December 2019. Data from institutions registered for the EPPIC audit was compiled and analysed for degree of compliance against more recently published national guidelines.
Results: Fifty (n = 50) sites submitted data, totalling 3189 skeletally mature patients. The median age was 26.7 (SD 0.5) years and 63.3 % were female. An isolated lateral release was performed in 8 %, an isolated medial patellofemoral ligament reconstruction (MPFLR) was performed in 37 % of patients and proximal realignment surgery was conducted in 8 % of patients. Trochleoplasty was required in 11 % of patients, with combined MPFLR and tibial tubercle osteotomy (TTO) being undertaken in 22 % of patients. Combined MPFLR, TTO and trochleoplasty was undertaken in 3 % of patients.
Conclusion: This audit highlights the national variation in surgical treatment of a common orthopaedic presentation. Despite the lack of evidence, an isolated lateral release is still being performed. There remains a lack of standardisation within the UK in the management of recurrent patellar instability, highlighting the need for national consensus of appropriate surgical interventions.
Keywords: Audit; Knee; National; Patella dislocation; Patellofemoral instability.
Copyright © 2025. Published by Elsevier B.V.
Conflict of interest statement
Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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