The efficacy of orthotics for anterior knee pain in military trainees. A preliminary report.

This study was undertaken to determine if commonly used orthotics (Palumbo "Dynamic Patellar Brace" [DynOrthotics, Vienna, Virginia] and the Cho-Pat Knee Strap [Cho-Pat Inc, Hainesport, New Jersey]) are helpful in the management of anterior knee pain in an active population who are unable to significantly modify their activity due to basic training requirements. In a prospective, randomized study, 59 Air Force Academy basic cadets who presented with anterior knee pain during the initial phases of basic cadet training, were placed into one of the three treatment groups. Group A was assigned no brace, group B was issued a Palumbo "Dynamic Patellar Brace," and group C was issued a Cho-Pat Knee Strap. All patients were started on physical therapy with "closed chain" rehabilitation and given nonsteroidal anti-inflammatory medications. Patients then underwent weekly follow-up with serial examinations and completion of a visual analog pain/motivation questionnaire. At the completion of training (6 to 8 weeks after study initiation), all charts were collected and statistically analyzed with analysis of variance (ANOVA). Eight patients were removed from the study group because of insufficient follow-up or failure to complete training (correlated with low motivation scales). There was no significant difference between the groups regarding change in pain throughout the study. The only statistically significant item was the proportion of females presenting with anterior knee pain (2.7% versus 1.4% incidence). Two patients voluntarily separated (disenrolled) due to incapacitating anterior knee pain at the completion of the study. Both of these patients were assigned to the Palumbo group. Despite manufacturer claims, these two orthotics do not appear to be effective in controlling anterior knee pain in this basic trainee populations.