Marcella F Pazzinatto, Natalie Mazzella, Larissa R Souto, Natalie J Collins, Kay M Crossley, Christian J Barton, Danilo De Oliveira Silva
Education did not demonstrate benefits compared with other interventions, and findings were highly variable depending on the comparator and the delivery method. Evidence for PFOA was limited to just 1 study. In addition, education interventions were poorly described across most studies, limiting interpretation and reproducibility.
AIMS: To synthesize the evidence on the comparative effectiveness of education compared with other interventions on pain and function in people with patellofemoral pain (PFP) or patellofemoral osteoarthritis (PFOA), and to appraise the content of education interventions.
DESIGN: Systematic review of randomized controlled trials.
PARTICIPANTS: People with PFP or PFOA.
INTERVENTION: Any education intervention compared with any non-pharmacological or non-surgical comparator.
OUTCOME MEASURES: Self-reported pain, self-reported function, and appraisal of content and delivery of education interventions.
RESULTS: Twenty randomized controlled trials were included (19 PFP, 1 PFOA), with 11 trials contributing to 6 meta-analyses. Overall, education resulted in worse short-term pain and function compared to exercise (mean difference [MD]: 1.46; 95% confidence interval [CI], 0.6 to 2.56 and standardized MD [SMD]: -0.87; 95% CI, -1.57 to -0.17, respectively) and multimodal physiotherapy (pain MD: 1.59; 95% CI, 0.06 to 3.12, and function SMD: -0.65; 95% CI, -1.19 to -0.10). However, when stratified by delivery mode, education delivered by a health professional showed no differences compared with exercise (pain MD: 0.80; 95% CI, -0.19 to 1.78, and function SMD: -0.52; 95% CI, -1.28 to 0.23), and passive interventions (pain MD: 0.71; 95% CI, -1.58 to 3.00) in the short-term, and multimodal physiotherapy (pain MD: 0.67; 95% CI, -0.37 to 1.72) in the medium-term. Educational material alone demonstrated worse short-term pain outcomes compared to exercise (MD: 2.53; 95% CI, 0.54 to 4.53). However, all comparisons were based on low- to very-low-certainty evidence. Educational interventions varied substantially in content, delivery, and reporting quality, with most trials providing incomplete descriptions of the education provided.
CONCLUSION: Education did not demonstrate benefits compared with other interventions, and findings were highly variable depending on the comparator and the delivery method. Evidence for PFOA was limited to just 1 study. In addition, education interventions were poorly described across most studies, limiting interpretation and reproducibility.
REGISTRATION: PROSPERO CRD420250651206.