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Comment & Response
June 12, 2018

Patient Education on Patellofemoral Pain

Author Affiliations
  • 1La Trobe Sport and Exercise Medicine Research Centre, Bundoora, Victoria, Australia
  • 2Research Unit for General Practice, Aalborg University, Aalborg, Denmark
JAMA. 2018;319(22):2338. doi:10.1001/jama.2018.4458

To the Editor Patellofemoral pain affects 1 in 14 individuals.1 We have concerns regarding the JAMA Patient Page on this common problem.2

The page was based on an opinion piece from 2007 and lacked consideration or acknowledgment of key research within the last 10 years, including multiple randomized clinical trials, culminating in 5 Cochrane reviews.3 This research has contributed to understanding and management of patellofemoral pain. Two key questions patients ask are “Why did I develop knee pain?” and “What is my long-term prognosis?” The Patient Page provided factually incorrect answers, suggesting that there is no long-term effect of patellofemoral pain despite current evidence demonstrating that up to 1 in 2 patients continues to experience pain that affects sports participation, quality of life, and general health.4 Furthermore, the emphasis on the role of shoes in the development and treatment of patellofemoral pain, along with rest and stretching as key interventions, is in contradiction to current evidence and understanding of pain. Up-to-date evidence emphasizes exercise therapy targeting both knee and hip muscle strength,3,5 along with foot orthoses to relieve pain in the short term.3 This key information is poorly articulated (exercise) or absent (foot orthoses).