Knee arthroscopy and exercise versus exercise only for chronic patellofemoral pain syndrome: a randomized controlled trial

Abstract

Background: Arthroscopy is often used to treat patients with chronic patellofemoral pain syndrome (PFPS). As there is a lack of evidence, we conducted a randomized controlled trial to study the efficacy of arthroscopy in patients with chronic PFPS.

Efficacy of Nonsurgical Interventions for Anterior Knee Pain

“…resection of inflamed/scarred/excessive medial plicae or synovium, abrasion of chondral lesions, discision of lateral capsule, repair of meniscal tears) was added to exercise therapy. [18] Consequently, there is widespread consensus that non-surgical interventions are the primary treatment of choice for AKP.…”

The Effects of Quadriceps Strengthening on Pain, Function, and Patellofemoral Joint Contact Area in Persons with Patellofemoral Pain

“…7 The usual management for PFPS is done through conservative treatment. 9 Physical exercises have long been reported to be effective in strengthening the muscles and soft tissues. 10 It has also been reported that a supervised physical therapy program could reduce pain and improve functions in patients with PFPS.…”

A Feasibility Study Comparing Two Chiropractic Protocols in the Treatment of Patellofemoral Pain Syndrome

“…On the other hand, the Patient Specific Functional Scale or PSS selected for inclusion secondary to its use in the highly rated PFPS 1,5,8,11,12,25,31,52,44,53 The PSS Overall Therapy Effectiveness Tool or even a Likert scale (allowing a broader variety and choice of response) is preferred. 54 Notably, trends in this pilot study are similar and comparable to previous studies.…”

“…1,11,25,30,31,52 A future fully powered PFPS trial, assessing 2 similar treatments, will need 57 patients per group or an N of 114 to detect an 8-to 10-point clinically meaningful difference between 2 groups using the AKPS at 80% power with a confidence level of 95% and an α = .05. 5,23,[59][60][61][62] In addition, based on previous published studies, a 10% dropout rate should be considered so that each group should be increased to reach an N = 125 or about n = 62 per group.…”

“…Exercise with or without manipulative and soft tissue therapy or, combined with other modalities such as orthotics, knee braces, and tape, demonstrates comparable short-term usefulness. [1][2][3][4][5][10][11][12][13][14][15][16][17][18] In clinical trials, manipulative therapy (defined as all grades of mobilization I-IV including manipulation or grade V high-velocity low-amplitude thrust) for PFPS has been restricted to patellofemoral joint mobilization with manipulation of lumbopelvic joints occasionally added. [1][2][3][4][5]8,[19][20][21] A few trials, designed to treat knee osteoarthritis, have also used full kinetic chain (FKC) manipulative therapy for joint dysfunction in the lumbosacral, hip, knee, ankle, and foot.…”