Knee and health related quality of life in patellofemoral joint pain

Mrs Sally Coburn1, Dr Christian Barton1, Dr Stephanie Filbay2, Professor Kay Crossley1

1La Trobe University, Bundoora, Australia, 2University of Oxford Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences Botnar Research Centre , Oxford , United Kingdom

Background

Patellofemoral joint pain (PFJP) is common in adolescents and adults, associated with a high prevalence of chronicity and has similar clinical features to early knee osteoarthritis. Physical impairments and functional deficits associated with PFJP are well documented and may detrimentally impact quality of life (QOL). However, a large body of literature related to the impact of PFJP on QOL has not previously been reviewed or synthesised.

Aim

To review and synthesise QOL outcomes for young adults and adolescents with PFJP and summarise the impact of interventions on QOL.

Method

We systematically identified all studies reporting QOL in individuals with PFJP, with a mean age under 50 years. Data extracted included knee-related and health-related QOL outcomes. Studies were methodologically appraised and comparisons made with population norms and healthy control groups.

Results

Eighteen studies reported QOL in 896 individuals with PFJP. Knee-related QOL measured by the Knee injury and Osteoarthritis Outcome Score (KOOS-QOL) in people with PFJP (mean +/- SD: 49 ± 21 to 78 ± 18) was lower than healthy adolescent controls (98±6 to 99±3) and young adult population norms (80±23 to 84±20). Physical component scores (PCS) from the SF-36 in people with PFJP (37±4 to 55±16) were lower than population norms (49±9 to 55±6). Physiotherapy intervention significantly improved KOOS-QOL scores by 6-12 points in adolescents with PFJP; and PCS scores by 8-9 points in adults with PFJP.

Significance of findings to allied health

QOL is clearly impaired in adolescents and adults with PFJP and may be improved through physiotherapy management.