Combined Hip and Knee Strengthening Compared With Knee Strengthening for Individuals With Lateral Patellar Dislocation: A Single-blind, Superiority, Randomized Controlled Trial.
Lucas Simões Arrebola, Toby O Smith, Vanessa Gonçalves Coutinho de Oliveira and 4 others
PMID 39006111WHAT IT FOUND
Adding hip exercises to knee strengthening did not improve knee function or pain more than knee strengthening alone at the end of treatment.
Both groups improved similarly, so you can choose either approach based on patient preference or concurrent hip issues.
Key findings
01There was no statistically significant difference between the knee-only and hip-plus-knee groups in the primary outcome (Lysholm Knee Score) at the 8-week endpoint or any follow-up time point.
02Secondary outcomes, including pain, patellar instability scores, quality of life, and recurrence of dislocation, showed no significant differences between the two groups at any time point.
03The study was underpowered because the sample size calculation used an effect size that is too large to be practical in human research.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study was underpowered because the sample size calculation assumed an unrealistically large effect size (Cohen's d of 1.06). No MRI was performed to assess patellofemoral anatomy, which might influence outcomes. The Norwich Patellar Instability Score was not used as the primary outcome because its minimal clinically important difference was unknown at the time of design. Kinesiophobia was not assessed, which is a known factor in patellar instability.
Declared interests
The authors declared no conflicts of interest. The study was funded by the Federal University of São Paulo and the Institute of Medical Assistance to the State Public Servant (IAMSPE).
The easy way to misread this
Do not conclude that hip strengthening is ineffective. The study was underpowered, and numerical trends favored the hip-plus-knee group for pain and instability scores, suggesting a potential benefit that this sample size could not confirm.