Effectiveness of Muscle Energy Technique, Strengthening, and Patellar Mobilization in the Physiotherapeutic Management of Patellofemoral Osteoarthritis.

Abstract

Introduction: Patellofemoral osteoarthritis (PFOA) is a prevalent degenerative joint disorder characterized by anterior knee pain, stiffness, reduced functional mobility, and impaired quality of life, particularly in older adults. Due to its multifactorial etiology-including muscle imbalance, altered patellar tracking, and joint degeneration-conservative physiotherapy approaches are often prioritized over surgical interventions. This study aimed to evaluate the clinical effectiveness of an integrated physiotherapeutic regimen comprising muscle energy technique (MET), targeted strengthening exercises, and patellar mobilization in the management of PFOA. These findings support the inclusion of multimodal manual therapy and targeted exercise interventions as first-line conservative management strategies for patellofemoral joint degeneration. However, due to the small sample size, further large-scale studies are warranted to enhance generalizability and confirm these results.

Materials and methods: A single-group pre- and post-interventional design was implemented involving 30 participants (aged 45-65 years) clinically and radiologically diagnosed with PFOA. The 6-week intervention protocol included MET applied to the quadriceps and hamstring muscle groups, progressive resistance strengthening exercises focusing primarily on the vastus medialis obliquus (VMO), and patellar mobilization techniques aimed at improving patellar tracking and joint mobility. Each participant received three supervised sessions per week. Outcome measures were assessed at baseline and post-intervention using the Visual Analog Scale (VAS) for pain intensity, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for pain, stiffness, and functional limitation, and the Kujala Anterior Knee Pain Scale for patellofemoral joint function.

Results: Statistical analysis revealed significant improvements across all outcome parameters post-intervention. Mean VAS scores decreased from 6.9 ± 1.2 to 3.1 ± 1.0 (P< 0.001), indicating substantial pain relief. WOMAC scores showed a marked reduction from 58.6 ± 5.4 to 34.2 ± 4.9 (p<0.001), reflecting improved joint function and reduced stiffness. The Kujala Score improved significantly from 45.7 ± 6.1 to 71.8± 5.6 (P<0.001), denoting enhanced patellofemoral mechanics and functional mobility.

Conclusion: The study demonstrates that a physiotherapy program integrating MET, quadriceps strengthening (with VMO emphasis), and patellar mobilization is effective in significantly reducing pain and improving functional outcomes in individuals with PFOA. These findings support the inclusion of multimodal manual therapy and targeted exercise interventions as first-line conservative management strategies for patellofemoral joint degeneration. However, due to the small sample size, further large-scale studies are warranted to enhance generalizability and confirm these results.