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Patellofemoral Pain: Updated Consensus Guidelines

January 14, 2019
Veronica Hackethal, MD

Symptoms persist in more than 50% of patients and may precede osteoarthritis.

Patellofemoral pain affects a wide range of patients, from adolescents to older adults. A consensus statement from the 5th International Patellofemoral Research Retreat, held in Australia in July 2017, focuses on exercise therapy and physical interventions for this common overuse disorder.1 Scroll through the slides for the highlights of the guidelines.

Patellofemoral pain, which occurs around or behind the patella during motion, affects about 23% of adults and 29% of adolescents.2 It may persist in more than 50% of people.3 The pain often results in inactivity and may precede osteoarthritis.

PEDro, Physiotherapy Evidence Database; RCT, randomized controlled trial.

Exercise therapy and physical interventions should always be the first-line treatments for patellofemoral pain.

The largest body of evidence supports exercise; hip and knee exercises should be combined.

Combined treatment with exercise and physical interventions (eg, orthoses, taping, and manual therapy) is recommended for up to 12 months. Prefabricated foot orthoses are an option for short-term pain control.

Patellofemoral knee or lumbar mobilization in the absence of exercise therapy and the use of electrophysical agents are not recommended.

References

1. Collins NJ, Barton CJ, van Middelkoop M, et al. 2018 Consensus statement on exercise therapy and physical interventions (orthoses, taping and manual therapy) to treat patellofemoral pain: recommendations from the 5th International Patellofemoral Pain Research Retreat, Gold Coast, Australia, 2017. Br J Sports Med. 2018;52:1170-1178. doi: 10.1136/bjsports-2018-099397

2. Smith BE, Selfe J, Thacker D, et al. Incidence and prevalence of patellofemoral pain: a systematic review and meta-analysis. PLoS One. 2018;13:e0190892. doi: 10.1371/journal.pone.0190892

3. Lankhorst NE, van Middelkoop M, Crossley KM, et al. Factors that predict a poor outcome 5-8 years after the diagnosis of patellofemoral pain: a multicentre observational analysis. Br J Sports Med. 2016;50:881-886. doi: 10.1136/bjsports-2015-094664.

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