Acupuncture Treatment of Patellofemoral Pain Syndrome

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Abstract
To evaluate the effect of acupuncture treatment in patellofemoral pain syndrome. A controlled trial where patients were randomly assigned either to acupuncture treatment or no treatment. Evaluation of the result was blinded. An acupuncture/physiotherapy treatment practice in Bergen, Norway. A total of 75 patients with patellofemoral pain syndrome were included, of whom 44 were female. Individualized acupuncture treatment twice weekly for 4 weeks. Patients were followed for 1 year with the Cincinnati Knee Rating System (CKRS) scale as the main outcome measure. Other tests used were the Stairs-Hopple test, quadriceps atrophy, and evaluating level pain after activity by a visual analogue scale. At inclusion patients, aged 18-45 (mean 31.0) years, reported persistent pain on activity (mean 6.6 years) and at rest (mean 4.3 years). CRS scores at baseline were similar (acupuncture group 58.0 versus no treatment group 56.1). At 12 months there was a significant difference in the CRS score between the groups (acupuncture 75.2 versus no treatment 61.7, p = 0.005). When analyzing for worst case, the difference persisted (68.1 versus 54.4, p = 0.03). Results were then dichotomized as to whether the patient was cured or not at 12 months. A patient was defined as cured if he/she scored "slight" or "none" on the "pain" or "limitation to activity" subscales. The Number Necessary to Treat (NNT) to cure one patient was NNT = 3.0 for the CRS pain subscale and NNT = 3.7 for the CRS function subscale. We conclude that acupuncture may be an alternative treatment for patellofemoral pain syndrome.