Patellofemoral Pain Syndrome Clinical Trial
Official title:
Botox for Non-surgical Lateral Release in Patellofemoral Pain
The purpose of this study is to determine whether the use of botulinum toxin A injected into the lateral thigh muscle improves knee function and reduces knee pain secondary to patellofemoral syndrome. The study hypothesis is that botulinum toxin + specific exercises will be superior to specific exercises alone in improving knee function and reducing knee pain in individuals with patellofemoral syndrome.
Patellofemoral pain syndrome is a leading cause of knee pain in persons under 45 and is
particularly common in women. The prevailing theory for the etiology of patellofemoral pain
is an imbalance in force or timing of the pull of the knee extensor muscles on the patella
resulting in improper tracking of the patella in the femoral grove. Specifically, the vastus
medialis is thought to be ineffective in overcoming the lateral pull of the vastus lateralis.
When exercises designed to focus on improving strength and timing of activation of the vastus
medialis fail, surgical release of part of the attachment of the vastus lateralis to the
patella is considered.
Botulinum toxin temporarily blocks acetylcholine release from motor neurons and is used
clinically to produce muscle relaxation.
Subjects with patellofemoral syndrome will be recruited into the study. Half of the subjects
will be given a placebo injection while the other half will be given an injection of Botox
(Botulinum Toxin A, Allergen) into the vastus lateralis muscle. Group assignment will be
randomized and a double blind protocol used. Prior to injection, the subject will record
their level of knee pain, fill out several knee function questionnaires, and have the
strength and endurance of their knee extensor muscles tested. All subjects will be given an
exercise program designed to target strengthening of the medial thigh muscles as well as
stretching of lateral structures.
At 4, 6 and 12 weeks knee pain and knee function will again be assessed.
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