title: Knee arthroscopy and exercise versus exercise only for chronic patellofemoral pain syndrome: 5-year follow-up.
abstract: OBJECTIVE
  To study the long-term outcome of arthroscopy in patients with chronic patellofemoral pain syndrome (PFPS), the authors conducted a randomised controlled trial. The authors also investigated factors predicting the outcome in patients with PFPS.
  
  
  METHODS
  Fifty-six patients with PFPS were randomised into two groups: an arthroscopy group (N=28), treated with knee arthroscopy and an 8-week home exercise programme, and a control group (N=28), treated with a similar 8-week home exercise programme only. The primary outcome was the Kujala score on pain and function at 5-year. Secondary outcomes were visual analogue scales (VASs) to assess activity-related symptoms.
  
  
  RESULTS
  According to the Kujala score, both groups showed a marked improvement during the 5-year follow-up: a mean improvement of 14.7 (95% CI 9.9 to 19.4) in the arthroscopy group and 13.5 (95% CI 8.1 to 18.8) in the controls. No differences between the groups in mean improvement in the Kujala score (group difference 1.2 (95% CI -8.4 to 6.1)) or in the VAS scores were found. None of the investigated factors predicted the long-term outcome, but in most of the cases the treatment result immediately after the exercise programme remained similar also after the 5-year follow-up.
  
  
  CONCLUSIONS
  Our RCT, being the first of its kind, indicates that the 5-year outcome in most of the patients with chronic PFPS treated with knee arthroscopy and home exercise programme or with the home exercise programme only is equally good in both groups. Some of the patients in both groups do have long-term symptoms.
authors.affiliation: Arcada University of Applied Sciences, Jan-Magnus Janssonin aukio 1, Helsinki, Finland. jyrki.kettunen@arcada.fi
authors.forename: Jyrki A
authors.initials: JA
authors.lastname: Kettunen
authors.forename: Arsi
authors.initials: A
authors.lastname: Harilainen
authors.forename: Jerker
authors.initials: J
authors.lastname: Sandelin
authors.forename: Dietrich
authors.initials: D
authors.lastname: Schlenzka
authors.forename: Kalevi
authors.initials: K
authors.lastname: Hietaniemi
authors.forename: Seppo
authors.initials: S
authors.lastname: Seitsalo
authors.forename: Antti
authors.initials: A
authors.lastname: Malmivaara
authors.forename: Urho M
authors.initials: UM
authors.lastname: Kujala
mesh_terms: D000328:Adult; D001182:Arthroscopy / Q000379:methods*; D002908:Chronic Disease; D003131:Combined Modality Therapy; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D057194:Intention to Treat Analysis; D008297:Male; D046788:Patellofemoral Pain Syndrome / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult