Physiotherapy, including quadriceps exercises and patellar taping, for knee osteoarthritis with predominant patello-femoral joint involvement: randomized controlled trial.

Abstract

OBJECTIVE: To design and carry out a randomized controlled trial of a complex, physical therapy based intervention for patello-femoral joint (PFJ) osteoarthritis (OA) of the knee, examining medium to longterm outcomes. METHODS: The participants, who had knee pain and predominant PFJ OA, were recruited from a large population based study. The study design was a controlled trial using prerandomization and a blind observer, comparing the intervention package with standard nonphysiotherapy treatment. The physiotherapy intervention was delivered in local community health centers and clinics and comprised education, quadriceps and functional exercises, and patellar taping delivered by a single physiotherapist in nine 30-minute sessions over 10 weeks, with advice to continue thereafter. The outcome measures were pain in the worse knee by 100 mm visual analog scale score, the disability domain of the Western Ontario and McMaster University OA index (WOMAC), and quadriceps muscle strength by maximum voluntary contraction. RESULTS: Eighty-seven patients were recruited to the study, 43 were randomized to the treatment arm. At 5 months post-baseline (10 weeks post-treatment) the treatment group had a small decrease in pain and a significant increase in quadriceps strength of the index knee. After one year there were no significant differences in any outcome measure, most of which had returned towards pretreatment levels. CONCLUSION: The treatment package produced small improvements in knee pain scores and quadriceps muscle strength 10 weeks after the end of the treatment period. There was no difference between the 2 groups at 12 months.