Petersen Wolf, Ellermann Andree, Rembitzki Ingo Volker, Scheffler Sven, Herbort Mirco, Brüggemann Gert Peter, Best Raymond, Zantop Thore, Liebau Christian
Klinik für Orthopädie und Unfallchirurgie, Martin Luther Krankenhaus Berlin, Grunewald, Caspar Theyß Strasse 27-31, 14193, Berlin, Germany.
Arcus Sportklinik, Pforzheim, Germany.
Arch Orthop Trauma Surg. 2016 Jul;136(7):975-82. doi: 10.1007/s00402-016-2464-2. Epub 2016 May 5.
It has been previously shown that exercise programs for patellofemoral pain syndrome (PFPS) can be supported by medially directed taping. Evidence supporting the use of patellar braces is limited because previous studies have been low quality. The aim of this study is to compare the outcomes of patients with PFPS after treatment with a medially directed patellar realignment brace and supervised exercise.
In a prospective randomized multicenter trial, 156 patients with PFPS were included and randomly assigned to 6 weeks of supervised physiotherapy in combination with the patellar realignment brace, or supervised physiotherapy alone. Outcome measures were the Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales, numeric analog pain scores, and the Kujala score at baseline, 6 weeks, 3 months, and 1 year after the start of therapy. The patient's self-reported perception of recovery was also assessed at these points.
Both treatment groups showed a significant improvement in all outcome measures over the study period. After 6 and 12 weeks of therapy, patients in the brace group had significantly higher KOOS sub-scale scores, a higher mean Kujala score, and less pain while climbing stairs or playing sports. After 54 weeks a group difference could be only detected for the KOOS ADL sub-scale.
The use of a medially directed realignment brace leads to better outcomes in patients with PFPS than exercise alone after 6 and 12 weeks of treatment. After 1 year of follow-up this positive effect diminished.
先前研究表明,针对髌股疼痛综合征(PFPS)的运动计划可通过向内侧贴扎得到支持。支持使用髌骨支具的证据有限,因为先前的研究质量较低。本研究的目的是比较使用向内侧调整髌骨的支具治疗与监督下的运动治疗后PFPS患者的治疗效果。
在一项前瞻性随机多中心试验中,纳入了156例PFPS患者,并将其随机分为两组,一组接受6周的监督下物理治疗并佩戴髌骨调整支具,另一组仅接受监督下的物理治疗。结局指标包括膝关节损伤和骨关节炎结局评分(KOOS)各子量表、数字模拟疼痛评分,以及治疗开始后基线、6周、3个月和1年时的库贾拉评分。在这些时间点还评估了患者自我报告的恢复感知情况。
在研究期间,两个治疗组的所有结局指标均有显著改善。治疗6周和12周后,佩戴支具组患者的KOOS子量表得分显著更高,平均库贾拉评分更高,且在爬楼梯或运动时疼痛更少。54周后,仅在KOOS日常生活活动(ADL)子量表上检测到组间差异。
在治疗6周和12周后,对于PFPS患者,使用向内侧调整的支具比单纯运动能带来更好的治疗效果。随访1年后,这种积极效果减弱。