J Orthop Sports Phys Ther. 2022 Nov;52(11):750-768. doi: 10.2519/jospt.2022.11359. Epub 2022 Sep 7.
To determine the effects of nonsurgical treatments on pain and function in people with patellofemoral pain (PFP). Systematic review with meta-analysis. We searched MEDLINE, Web of Science, and Scopus databases from their inception until May 2022 for interventional randomized controlled trials (RCTs) in people with PFP. We included RCTs that were scored ≥7 on the PEDro scale. We extracted homogenous pain and function data at short- (≤3 months), medium- (>3 to ≤12 months) and long-term (>12 months) follow-up. Interventions demonstrated if outcomes were superior to sham, placebo, or wait-and-see control. Interventions demonstrated if outcomes were superior to an intervention with primary efficacy. We included 65 RCTs. Four interventions demonstrated short-term : knee-targeted exercise therapy for pain (standardized mean difference [SMD], 1.16; 95% CI: 0.66, 1.66) and function (SMD, 1.19; 95% CI: 0.51, 1.88), combined interventions for pain (SMD, 0.79; 95% CI: 0.26, 1.29) and function (SMD, 0.98; 95% CI: 0.47, 1.49), foot orthoses for global rating of change (OR = 4.31; 95% CI: 1.48, 12.56), and lower-quadrant manual therapy for function (SMD, 2.30; 95% CI: 1.60, 3.00). Two interventions demonstrated short-term compared to knee-targeted exercise therapy: hip-and-knee-targeted exercise therapy for pain (SMD, 1.02; 95% CI: 0.58, 1.46) and function (SMD, 1.03; 95% CI: 0.61, 1.45), and knee-targeted exercise therapy and perineural dextrose injection for pain (SMD, 1.34; 95% CI: 0.72, 1.95) and function (SMD, 1.21; 95% CI: 0.60, 1.82). Six interventions had positive effects at 3 months for people with PFP, with no intervention adequately tested beyond this time point. .
评估非手术治疗对髌股疼痛（PFP）患者疼痛和功能的影响。系统评价与荟萃分析。我们检索了 MEDLINE、Web of Science 和 Scopus 数据库，以获取从创建到 2022 年 5 月期间针对 PFP 患者的介入性随机对照试验（RCT）。我们纳入了 PEDro 量表评分≥7 的 RCT。我们提取了短期（≤3 个月）、中期（>3 至≤12 个月）和长期（>12 个月）随访时具有同质性的疼痛和功能数据。如果干预措施的结果优于假手术、安慰剂或等待观察对照组，则表示干预措施具有优越性。如果干预措施的结果优于具有主要疗效的干预措施，则表示干预措施具有优越性。我们纳入了 65 项 RCT。4 种干预措施在短期显示出优越性：针对膝关节的运动疗法治疗疼痛（标准化均数差 [SMD]，1.16；95%置信区间：0.66，1.66）和功能（SMD，1.19；95%置信区间：0.51，1.88），联合干预治疗疼痛（SMD，0.79；95%置信区间：0.26，1.29）和功能（SMD，0.98；95%置信区间：0.47，1.49），足部矫形器治疗整体变化评分（OR = 4.31；95%置信区间：1.48，12.56），以及下肢象限手动治疗功能（SMD，2.30；95%置信区间：1.60，3.00）。2 种干预措施与针对膝关节的运动疗法相比，在短期显示出优越性：针对髋关节和膝关节的运动疗法治疗疼痛（SMD，1.02；95%置信区间：0.58，1.46）和功能（SMD，1.03；95%置信区间：0.61，1.45），以及针对膝关节的运动疗法和周围神经内葡萄糖注射治疗疼痛（SMD，1.34；95%置信区间：0.72，1.95）和功能（SMD，1.21；95%置信区间：0.60，1.82）。6 种干预措施在 3 个月时对 PFP 患者有积极影响，但没有一种干预措施在这一时间点之后得到充分测试。。
