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Osteoarthritis of the knee - Keeping it Taped!

Osteoarthritis of the knee is one of the most common causes of chronic pain and disability in the community, and especially the elderly. Treatment is usually with physiotherapy and use of analgesic and anti-inflammatory drugs, measures which are expensive and carry some dangers for patients.

A really simple way of doing something that is effective, is simple, is cheap, and is under the control of the patient has been reported from Bristol.

Randomised controlled trial

Fourteen patients attending a rheumatology clinic had radiographic evidence of osteoarthritis in the patellofemoral compartment. All had anterior knee pain, difficulty with walking and had trouble with stairs and steps.

Patients had their knees taped: taping was:-
  • Neutral - with the tape applied directly over the front of the patella, without any pressure.
  • Medial - with the tape pulling the patella to the medial side of the knee.
  • Lateral - with the tape pulling the patella to the lateral side of the knee.
Patients had their knees taped for four days, and crossed over to all three methods of taping with a three day interval. The order of the three treatments was randomised. Scores for the overall pain on each of the four days were recorded for each treatment.

The results

The medial tape resulted in a 25% reduction in knee pain compared with neutral or lateral taping. It was significantly better than the other two methods.

The implications

Patellofemoral joint osteoarthritis is common, causing considerable pain and disability and representing a serious healthcare problem. The Bristol group report that patients were able to apply their own tape after minimal instruction, providing them with a low cost, easy means of treatment under their own control.

Reference:

Cushnaghan et al. British Medical Journal 1994 308: 753-5.

Questions to be Answered

Q: What need is met by this intervention?
A: Significant reductions in pain with patients with arthritic knees.
Q: What happens at present?
A: Patients have physiotherapy and/or are treated with analgesics or anti-inflammatory drugs.
Q: Is quality improved?
A: Yes-pain is reduced and patients should have more control over their own treatment.
Q: What are the cost implications?
A: Should reduce costs in drugs budgets and may reduce pressure on physiotherapy services. Cost benefits are not quantified.
Q: Is more information needed?
A: Yes: this study examined 14 patients only. Longer term studies with more patients are needed to define efficacy, safety and cost-effectiveness.

Advice to Health Authorities and GPFHs

  • Will increase quality or effectiveness
  • Likely to reduce costs
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