Six treatments have positive effects at three-months for people with patellofemoral pain: a systematic review with meta-analysis
To determine the effects of non-surgical treatments on pain and function in people with patellofemoral pain (PFP).
Systematic review with meta-analysis.
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.
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.
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).