Six treatments have positive effects at three-months for people with patellofemoral pain: a systematic review with meta-analysis

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Objective

To determine the effects of non-surgical treatments on pain and function in people with patellofemoral pain (PFP).

Design

Systematic review with meta-analysis.

Literature Search

We searched Medline, Web of Science, and Scopus to May 2022 for interventional randomised controlled trials (RCTs) in people with PFP.

Study Selection Criteria

We included RCTs that were scored >7 on the PEDro scale.

Data Synthesis

We extracted homogenous pain and function data at short- (<3 months), medium- (>3 to <12 months) and long-term (>12 months) follow up. Interventions demonstrated primary efficacy if outcomes were superior to sham, placebo, or wait-and-see control. Interventions demonstrated secondary efficacy if outcomes were superior to an intervention with primary efficacy.

Results

We included 65 RCTs. Four interventions demonstrated short-term primary efficacy: knee-targeted exercise therapy for pain (SMD 1.16, 95% CI 0.66, 1.66) and function (SMD 1.19, 95% CI 0.51, 1.88), combined interventions for pain (SMD 0.79, 95% CI 0.26, 1.29) and function (SMD 0.98, 95% CI 0.47, 1.49), foot orthoses for global rating of change (OR 4.31, 95% CI 1.48, 12.56), and lower-quadrant manual therapy for pain (SMD 2.30, 95% CI 1.60, 3.00). Two interventions demonstrated short-term secondary efficacy compared to knee-targeted exercise therapy: hip-and-knee-targeted exercise therapy for pain (SMD 1.02, 95% CI 0.58,1.46) and function (SMD 1.03, 95% CI 0.61, 1.45), and knee-targeted exercise therapy and perineural dextrose injection for pain (SMD 1.34, 95% CI 0.72, 1.95) and function (SMD 1.21, 95% CI 0.60, 1.82).

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