Management of patellofemoral joint osteoarthritis using biomechanical device therapy: a systematic review with meta-analysis

Abstract Background Current clinical guidelines recommend conservative management including non-pharmacologic therapy prior to considering surgery for knee OA. There is a paucity of trials investigating the use biomechanical device therapies on those with patellofemoral joint osteoarthritis (PFJOA). The aim was systematically review effectiveness devices (bracing, taping, and footwear) in symptomatic PFJOA. Method Cochrane, PEDro, MEDLINE, CINAHL, AMED EMBASE electronic databases were search from inception October 31, 2020. Included studies randomised controlled or studying any form PFJOA English language. Studies included quality-appraised using PEDro scoring system. Result Eleven identified which assessment either patellar foot orthotics, bracing combined physiotherapy treatments. Trial quality ranged ‘poor’ through ‘fair’ ‘good’. For bracing, pooled analysis two good showed no overall significant improvement visual analogue scale (VAS) (random effects (RE) standardised mean difference (SMD) = −0.42 (95%CI −1.12 +0.29). Pooled data same non-significant favour assessed by KOOS/WOMAC (RE SMD −0.18 −0.66 +0.31). Two ‘good’ applying tape reduction pain immediately after application 4 days. A trial orthotic 6 weeks between groups adjusted maximum VAS 21.9 mm (95% CI − 2.1 46.0) 8.1 CI− 6.9 23.1) KOOS pain. multimodal intervention (which taping studies) (SMD −0.4; −0.71 −0.09) at 3 months compared controls. Conclusion some evidence that approach significantly reduces short-term Long-term all interventions are still unknown, indicates need further research determine longer term impact outcomes