Email updates

Keep up to date with the latest news and content from BMC Medicine and BioMed Central.

Journal App

google play app store
Open Access Highly Accessed Research article

Knee arthroscopy and exercise versus exercise only for chronic patellofemoral pain syndrome: a randomized controlled trial

Jyrki A Kettunen1*, Arsi Harilainen2, Jerker Sandelin2, Dietrich Schlenzka2, Kalevi Hietaniemi3, Seppo Seitsalo2, Antti Malmivaara4 and Urho M Kujala5

Author Affiliations

1 The ORTON Research Institute, Invalid Foundation, Tenholantie 10, FIN-00280 Helsinki, Finland

2 The ORTON Orthopaedic Hospital, Invalid Foundation, Tenholantie 10 FIN-00280 Helsinki, Finland

3 The Helsinki University Central Hospital, Jorvi Hospital, Turuntie 150, FIN-02740 Espoo, Finland

4 The Finnish Office for Health Care Technology Assessment/National Research and Development Centre for Welfare and Health, Lintulahdenkuja 4, FIN-00530 Helsinki, Finland

5 The Department of Health Sciences, University of Jyväskylä, P.O. Box 35, FIN-40014 University of Jyväskylä, Finland

For all author emails, please log on.

BMC Medicine 2007, 5:38  doi:10.1186/1741-7015-5-38

Published: 13 December 2007

Abstract

Background

Arthroscopy is often used to treat patients with chronic patellofemoral pain syndrome (PFPS). As there is a lack of evidence, we conducted a randomized controlled trial to study the efficacy of arthroscopy in patients with chronic PFPS.

Methods

A total of 56 patients with chronic PFPS were randomized into two treatment groups: an arthroscopy group (N = 28), treated with knee arthroscopy and an 8-week home exercise program, and a control group (N = 28), treated with the 8-week home exercise program only. The arthroscopy included finding-specific surgical procedures according to current recommendations. The primary outcome was the Kujala score on patellofemoral pain and function at 9 months following randomization. Secondary outcomes were visual analog scales (VASs) to assess activity-related symptoms. We also estimated the direct healthcare costs.

Results

Both groups showed marked improvement during the follow-up. The mean improvement in the Kujala score was 12.9 (95% confidence interval (CI) 8.2–17.6) in the arthroscopy group and 11.4 (95% CI 6.9–15.8) in the control group. However, there was no difference between the groups in mean improvement in the Kujala score (group difference 1.1 (95% CI -7.4 - 5.2)) or in any of the VAS scores. Total direct healthcare costs in the arthroscopy group were estimated to exceed on average those of the control group by €901 per patient (p < 0.001).

Conclusion

In this controlled trial involving patients with chronic PFPS, the outcome when arthroscopy was used in addition to a home exercise program was no better than when the home exercise program was used alone.

Trial registration

Current Controlled Trials ISRCTN 41800323