2026 AAOS Annual Meeting: Randomized and Controlled Trial for a Novel Digital Therapeutic for Treatment of Patellofemoral Pain, a Dilemma in Orthopedics

Two hundred sixteen patients with chronic patellofemoral pain of at least three months’ duration and minimal or no radiographic osteoarthritis were randomized to receive a mobile app–based digital therapeutic program integrating personalized exercise therapy and cognitive behavioral therapy (n=108) or standard care consisting of a single face-to-face exercise education session with educational materials and self-directed exercise logs (n=108). The outcomes of interest were changes in usual and worst pain measured by a visual analogue scale, functional disability measured by the Anterior Knee Pain Scale (AKPS), quality of life using the EQ-5D-5L, pain catastrophizing using the Pain Catastrophizing Scale (PCS), depressive symptoms using the Patient Health Questionnaire-9, and exercise adherence. Outcomes were assessed at baseline and at 4, 8, and 12 weeks. Overall, the results of the study revealed that the digital therapeutic group experienced significantly greater reductions in usual pain (P < 0.001 at weeks 8 and 12) and worst pain (P = 0.008 at week 8; P < 0.001 at week 12), along with improved function and quality of life compared with the control group. These findings suggest that a mobile app–based program combining exercise therapy and cognitive behavioral therapy may provide an effective nonsurgical treatment option for patients with patellofemoral pain.