What is the evidence for pharmacotherapy in the treatment of patellofemoral pain syndrome?
AMSTAR Rating
Summary
Patient Population:
No information on the patient population was provided.
Intervention:
Medications used in the identified studies included: NSAIDs (4 trials), glycosaminoglycan polysulphate (GAGPS intramuscular or intra-articular injection: 2 studies), and nandrolone phenylpropionate injection (1 study).
Comparison:
There were 8 studies identified for inclusion. Only 3 studies were rated as being at low risk of bias (high quality). Primary outcome assessed was pain.
Outcome:
- NSAIDs: Limited evidence for the effectiveness of NSAIDs in the treatment of PFPS in the short-term.
- Glucocorticoid Steroid Injection: The reporting quality of this study was noted to be very poor – no statistics, point estimates, estimates of variability are reported – conclusions are, therefore, not possible.
- Anabolic Steroids: Significantly more individuals treated with nandrolone injections demonstrated improvement than those assigned to the placebo condition (RR=17.39, 2.56, 118.26). Bone density results also appeared to be increased in the group receiving treatment with nandronlone injections (RR 13.91, 95% CI 2.01, 95.79). This represents limited evidence that nandronlone may be more effective than placebo for the improvement of clinical symptoms for individuals diagnosed with chondromalacia patellae.
- GAGPS: One study demonstrated significant benefit associated with intra-articular injection (vs.no injection) based on the number of individuals without symptoms in a full squat assessed at 6 weeks (RR=2.2, 95% CI 1.03, 4.68). This difference was not sustained over time. The authors state that there is conflicting evidence regarding the effectiveness of GAGPS injections.
