Patellofemoral Pain Syndrome
Conditions
Keywords
Viscosupplementation, Hyaluronic acid, Synvisc, Synvisc-One, Patellofemoral pain syndrome, PFPS, Anterior knee pain, Runner's knee
Brief summary
Patellofemoral pain syndrome (PFPS) is the most common overuse injury seen in the athletic population, particularly amongst runners. The standard of care treatment for PFPS is a comprehensive active rehabilitation program. Eighty percent of patients with PFPS report improvement in their symptoms with such a program. Unfortunately, the remaining twenty percent fail to achieve adequate symptom relief with rehabilitation alone. Considering the enormous number of individuals running for fitness, PFPS represents a significant challenge to public health as the investigators strive to encourage active living in our society. A relationship between PFPS and the development of patellofemoral osteoarthritis (PFOA) has been suggested in scientific literature. Given that intra-articular viscosupplementation (hyaluronic acid) injections have shown clinically significant symptom improvement in knee osteoarthritis, and PFPS is likely on the same spectrum, the investigators propose a trial for therapy-resistant PFPS. Hyaluronic acid is a naturally occurring molecule found in the synovial fluid of freely movable joints (such as the knee). It is believed to contribute to lubrication and cushioning in these joints. The composition of synovial fluid within arthritic joints is altered, resulting in reduced fluid viscosity and elasticity. One modern formulation of hyaluronic acid is Hylan G-F 20 (Synvisc-One, Sanofi Canada). This treatment is offered as a single injection and will be utilized in this clinical trial.
Interventions
DEVICEHylan G-F 20
Intra-articular injection of 6 mL Hylan G-F 20
Sponsors
University of Calgary
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 45 Years
Healthy volunteers
No
Inclusion criteria
1. Adults aged 18-45 2. Previously diagnosed with PFPS that failed to improve with at least 6 weeks of active rehabilitation, supervised by physiotherapist. 3. Retropatellar or peripatellar knee pain for a minimum of 2 months 4. Pain aggravated by at least two of the following patellofemoral joint loading activities: squatting, running, ascending or descending stairs, or sitting with prolonged knee flexion 5. Pain with patellar grind test on clinical examination 6. Visual Analog Scale (VAS) \> 4/10 with patellofemoral joint loading activities 7. Normal knee x-ray
Exclusion criteria
1. X-ray evidence of osteoarthritis or fracture 2. Meniscal or ligamentous injury suspected clinical examination 3. Previous knee surgery 4. History of patellar instability or positive patellar apprehension test 5. Any contraindication to knee injection (overlying skin or joint infection, joint effusion, coagulopathy, previous adverse reaction etc.) 6. Known allergy to avian products 7. Previous knee injection within the last 3 months 8. Pregnant or breastfeeding
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Pain measured using the visual analog scale (VAS) | 6 weeks |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Function measured using the Anterior Knee Pain Scale (AKPS) | 6 weeks and 12 weeks | — |
| Pain measured using the visual analog scale (VAS) | Weekly until 12 weeks post injection | — |
| Kinetic and kinematic data | Baseline compared to 6 weeks post injection | Data will be collected using a 3-D motion analysis system with 8 cameras and an instrumented treadmill |
Countries
Canada
Contacts
Primary ContactJordan Raugust
Backup ContactReed Ferber
Outcome results
None listed