Targeted physiotherapy for patellofemoral joint osteoarthritis: a protocol for a randomised, single-blind controlled trial

BMC Musculoskelet Disord. 2008 Sep 16;9:122. doi: 10.1186/1471-2474-9-122.

Abstract

Background: The patellofemoral joint (PFJ) is one compartment of the knee that is frequently affected by osteoarthritis (OA) and is a potent source of OA symptoms. However, there is a dearth of evidence for compartment-specific treatments for PFJ OA. Therefore, this project aims to evaluate whether a physiotherapy treatment, targeted to the PFJ, results in greater improvements in pain and physical function than a physiotherapy education intervention in people with symptomatic and radiographic PFJ OA.

Methods: 90 people with PFJ OA (PFJ-specific history, signs and symptoms and radiographic evidence of PFJ OA) will be recruited from the community and randomly allocated into one of two treatments. A randomised controlled trial adhering to CONSORT guidelines will evaluate the efficacy of physiotherapy (8 individual sessions over 12 weeks, as well as a home exercise program 4 times/week) compared to a physiotherapist-delivered OA education control treatment (8 individual sessions over 12 weeks). Physiotherapy treatment will consist of (i) quadriceps muscle retraining; (ii) quadriceps and hip muscle strengthening; (iii) patellar taping; (iv) manual PFJ and soft tissue mobilisation; and (v) OA education. Resistance and dosage of exercises will be tailored to the participant's functional level and clinical state. Primary outcomes will be evaluated by a blinded examiner at baseline, 12 weeks and 9 months using validated and reliable pain, physical function and perceived global effect scales. All analyses will be conducted on an intention-to-treat basis using linear mixed regression models, including respective baseline scores as a covariate, subjects as a random effect, treatment condition as a fixed factor and the covariate by treatment interaction.

Conclusion: This RCT is targeting PFJ OA, an important sub-group of knee OA patients, with a specifically designed conservative intervention. The project's outcome will influence PFJ OA rehabilitation, with the potential to reduce the personal and societal burden of this increasing public health problem.

Trial registration: Australia New Zealand Clinical Trials Registry ACTRN12608000288325.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Athletic Tape
  • Femur / physiopathology
  • Follow-Up Studies
  • Humans
  • Knee Joint / physiopathology*
  • Linear Models
  • Middle Aged
  • Muscle Strength / physiology
  • Osteoarthritis, Knee / physiopathology*
  • Osteoarthritis, Knee / rehabilitation
  • Osteoarthritis, Knee / therapy*
  • Outcome Assessment, Health Care
  • Patella / physiopathology
  • Patient Education as Topic*
  • Physical Therapy Modalities*
  • Single-Blind Method
  • Treatment Outcome