#021-Effective Interventions for Patellofemoral Pain

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Effective Interventions for Patellofemoral Pain

This is a living systematic review with network meta-analysis, to compare the effectiveness of interventions for Patellofemoral pain (PFP).

?Conclusion

• Wait-and-see approach is NOT recommended.
• Education combined with physical treatment such as exercise, orthoses, patellar taping or mobilization can be the most effective approach.
• No conclusion regrading the superiority of a specific type of intervention or a combination of interventions.

?Results

Included 22 RCTs and 1472 participant with 6 weeks or more of patelloremoral pain.

Here is a link to see more details about the interventions from the included studies. (Page 33 and after).

Any improvement at 3 months

• All treatments were superior to wait-and-see.
• Education+ exercise+ patellar taping/mobilisations, with or without orthosis, was superior to education alone.
• Exercise alone or orthosis+ education are not superior to education alone.
• No specific type of exercise was superior to another type of exercise.

Any improvement at 12 months

• No differences were found for education+ exercise+ patellar taping/mobilisation, education+ orthosis or education+ exercise+ patellar taping/mobilisations+ orthosis when compared with education alone.

Effective treatment combinations

At 3 months:

• Education+exercise+patellar taping/mobilisations, either with or without orthosis are the best treatment combination.
• Wait and see was least likely to be effective

At 12 months:

• Education+exercise+patellar taping/mobilisations, either with or without orthosis are similar to education+ orthosis.
• Education alone was the least to be effective.

Effect of treatments on worst pain

• At 3 months, none of the treatments was found to be superior to any other treatment or to wait-and-see.
• At 12 months, education+exercise+patellar taping/mobilisations superior to education alone.
• Education+exercise+patellar taping/mobilisations+orthosis appears better than education alone but was not found to be superior to education+exercise+patellar taping/mobilisations.

Effect of treatments on pain while descending stairs:

• At 3 months, an exercise programme including hip, knee and trunk exercises was superior to hip and knee exercises alone and to a programme including ‘minimal’ hip/knee exercises, also no difference was found between minimal hip/knee exercises and usual hip/knee exercises.
• At 12 months, hip, knee and trunk exercises were superior to a combination of hip/knee exercises and arthroscopy, and also superior to hip/knee exercises alone, and no difference was found between hip/knee exercises+arthroscopy or hip/knee exercises alone.

?️Note:

• This is a living systematic review and meta-analysis, which means the authors will keep updating this article, they stated that it will be updated annually for a minimum of 5 years.

Reminder: Report #005 covered an article about effective methods to prevent patellofemoral pain in athletes.

?️Recommended reads:

• The effect of running on knee joint cartilage: A systematic review and meta-analysis. (Open Access)

References

• Comparative effectiveness of treatments for patellofemoral pain: a living systematic review with network meta-analysis. (Open Access)

*Calculation is based on the average reading speed that around 200 words per minute (wpm).