Ferner Felix, Schenke Maximilian, Lutter Christoph, Petersen Wolf, Efe Turgay, Schmeling Arno, Izadpanah Kaywan, Perwanger Florian, Harrer Jörg, Dickschas Jörg
Sana Kliniken Oberfranken, Lichtenfels, Germany.
Department of Orthopaedic Surgery, University Medical Center Rostock, Rostock, Germany.
Arch Orthop Trauma Surg. 2025 Mar 12;145(1):180. doi: 10.1007/s00402-025-05787-y.
Anterior knee pain is a frequent symptom caused by disorders like patellofemoral pain syndrome or patella tendon tendinitis, which is commonly treated conservatively. The aim of the current study was to examine the effectiveness of a digital therapeutic (DT) versus German standard care through a prospective, randomized, multicenter controlled trial.
Study participants were recruited in 9 orthopedic specialist centers diagnosed with anterior knee pain and a NPRS score of ≥ 4. Stratified randomization for n = 140 participants was conducted, assigning participants to the intervention group (exclusive use of DT) or the control group (standard care). Standard care included 1-3 prescriptions for physical therapy, while the DT consisted of a 90-day personalized exercise therapy program including educational content. The primary endpoints were pain measured by NPRS and functional impairment measured by the Kujala Score.
The use of the DT compared to the standard care showed an improvement in clinical outcomes (NPRS = - 3.7 ± 2.67 and Kujala = 18.00 ± 13.96, both p < 0.001). Both pain and function improved clinically and statistically significantly compared to the control group (ANOVA: NPRS = - 1.64 ± 0.35, p < 0.001, Kujala = 9.26 ± 2.52, p < 0.01).
The use of the DT showed significant improvements in pain and function compared to the current standard therapy. These results are highly relevant for clinical practice in the treatment decision-making for patients with anterior knee pain as the DT bridges effectively gaps in the healthcare systems.
膝前痛是由髌股疼痛综合征或髌腱炎等疾病引起的常见症状，通常采用保守治疗。本研究的目的是通过一项前瞻性、随机、多中心对照试验，检验数字疗法（DT）与德国标准护理的有效性。
在9个骨科专科中心招募被诊断为膝前痛且数字疼痛评分量表（NPRS）得分≥4的研究参与者。对140名参与者进行分层随机分组，将参与者分配到干预组（仅使用DT）或对照组（标准护理）。标准护理包括1 - 3张物理治疗处方，而DT包括一个为期90天的个性化运动治疗方案，其中包含教育内容。主要终点是用NPRS测量的疼痛和用库贾拉评分测量的功能障碍。
与标准护理相比，使用DT显示出临床结果的改善（NPRS = - 3.7±2.67，库贾拉评分为18.00±13.96，两者p < 0.001）。与对照组相比，疼痛和功能在临床和统计学上均有显著改善（方差分析：NPRS = - 1.64±0.35，p < 0.001，库贾拉评分= 9.26±2.52，p < 0.01）。
与当前标准治疗相比，使用DT在疼痛和功能方面有显著改善。这些结果对于膝前痛患者治疗决策的临床实践具有高度相关性，因为DT有效地弥补了医疗系统中的差距。
