A 33-year-old female patient presents with 10 years of anterior knee pain that is progressively worsening. She has pain with weightbearing activities, when climbing stairs, kneeling, and squatting.
On examination, she has a mild knee effusion, normal knee alignment and patellar mobility, range of motion of 0° to 125°, and mild crepitus.
Radiographs show preservation of the joint space. Despite several nonoperative interventions, including daily nonsteroidal anti-inflammatory drugs, occasional corticosteroid injections, and weight loss, she continues to have pain and limitations in her activities.
Which of the additional following treatment modalities is most appropriate for this patient?
Remediation:
A. Bracing in the absence of a ligament injury or instability has not been shown to reliably improve anterior knee pain.
B. The history and examination are consistent with patellofemoral pain. Low-impact exercises, weight loss, and activity modifications more consistently relieve pain and improve function in patients with symptomatic anterior knee pain.
C. Evidence in the efficacy of glucosamine-chondroitin supplementation is currently lacking.
D. There is no robust evidence supporting the use of stem cell therapies in the management of anterior knee pain in a young patient.