Patellar mobilization therapy (PMT) plus exercise has the potential to reduce pain and improve function and quality of life for patients with knee osteoarthritis, according to a phase 2 study published Nov. 12 in the Annals of Family Medicine

Regina Wing Shan Sit, M.B.B.S., from the Chinese University of Hong Kong, and colleagues randomly assigned 208 primary care patients with knee osteoarthritis to either an intervention group (three PMT treatment sessions from primary care physicians at two-month intervals with concomitant prescription of a home-based vastus medialis oblique muscle exercise) or a control group, who were put a waitlist.

The knee joint, a complex tri-compartment structure, comprises the patellofemoral joint and the tibiofemoral joint. The coexistence of patellofemoral joint osteoarthritis and tibiofemoral joint osteoarthritis is observed in 40% of older adults with knee osteoarthritis.

Previous studies have indicated that patellofemoral joint osteoarthritis is a major source of pain in knee osteoarthritis and that the concomitant occurrence of patellofemoral joint osteoarthritis and tibiofemoral joint osteoarthritis causes a greater degree of pain and loss of function.

Physical function tests

The researchers found a greater improvement in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score in the intervention group than in the control group at 24 weeks.

They also observed significant differences in all secondary outcomes between the groups, including the WOMAC composite, function, and stiffness scores; the visual analog scale score for pain; and objective physical function tests (30-second chair stand, 40-minute walk test, timed up and go test, and EuroQol-5D).

"Future clinical trials with comparison to other active comparator controls will help determine the overall efficacy and facilitate the deployment of PMT in real-world practice," the authors write.