The effectiveness of dry needling in patellofemoral pain syndrome patients: A systematic review and meta-analysis

Background

Patellofemoral pain syndrome (PFPS) is a condition characterized by anterior knee pain and functional impairments. Dry Needling (DN) is a minimally invasive and studies on the effectiveness of DN in PFPS treatment have shown conflicting results, warranting further research.

Methods

The databases PubMed, Embase, Web of Science, Cochrane, and Google Scholar were searched. We followed the PICOS principle to develop the inclusion criteria. Eligibility criteria were applied to titles, abstracts, and full-texts. We used Cohen's d and random effects modeling to conduct a meta-analysis.

Results

Ten articles satisfied eligibility including 466 patients. Significant reduction in pain intensity compared to other interventions or no intervention was found (SMD = −0.53; 95 % CI: (−0.90; −0.15); P-value = 0.0059; I2: 85.2 %). In the mid-term follow-up, a significant improvement was demonstrated (SMD = −1.40; 95 % CI: (−2.39; −0.40); P-value = 0.006). Pain intensity reduction was significant in the Quadriceps and Gluteus Medius (SMD = −0.49 and −1.49; 95 % CI: (−0.92, −0.07) and (−2.16, −0.81); P-value = 0.024 and < 0.0001). Additionally, pain reduction was significant when punctuating 3 trigger points (SMD = −1.83; 95 % CI: (−2.34, −1.31); P-value< 0.0001; I2: 73.1 %). There was also a significant increase in Kujala score after DN, particularly in short-term and mid-term follow-up durations (SMD = 0.45 and 1.31; 95 % CI: (0.05, 0.84) and (0.48, 2.14); P-value = 0.026 and 0.002).

Conclusions

This study approved the effectiveness of dry needling on pain intensity and physical function in patients with patellofemoral PFPS especially in 1–3 months after intervention, administrating in 3 points and on Quadriceps and Gluteus Medius muscles.