EFFECT OF HIP ABDUCTOR STRENGTHENING COMBINED WITH PATELLAR TAPING ON PAIN AND FUNCTION IN PATIENTS WITH HOFFA’S FAT PAD IMPINGEMENT SYNDROME

Abstract

Background: Hoffa’s fat pad impingement syndrome (HFPIS) is a potential source of anterior knee pain that may impair movement and functional performance. Proximal biomechanical deficits, including reduced hip abductor strength and altered lower-limb control, may contribute to increase mechanical loading around the knee. Hip abductor strengthening may address these proximal deficits, whereas patellar taping may provide local mechanical and symptomatic support. However, evidence regarding their combined application remains limited. This study evaluated the effects of hip abductor strengthening combined with patellar taping on pain, functional ability, hip abductor strength, and knee range of motion in patients with HFPIS.

Objective: To determine the effect of hip abductor strengthening combined with patellar taping on pain, functional ability, hip abductor strength, and knee range of motion in patients with HFPIS.

Methods: A randomized controlled trial was conducted over a 6-month study period among 30 participants with HFPIS, randomly allocated to an experimental group (n=15) and a control group (n=15). The experimental group received hip abductor strengthening exercises, including clamshells and side-lying hip abduction, combined with McConnell patellar taping, whereas the control group received conventional physiotherapy comprising quadriceps strengthening, stretching, and physical modalities. The intervention was administered for 6 weeks. Pain, functional ability, hip abductor strength, and knee range of motion were assessed using the Numeric Pain Rating Scale, Kujala Anterior Knee Pain Scale, handheld dynamometry, and goniometry, respectively, before and after treatment. Within- and between-group differences were analyzed using appropriate statistical tests, with statistical significance set at p≤0.05.

Results: No significant baseline differences were observed between groups for the assessed outcomes (p>0.05). Both groups demonstrated significant within-group improvements following treatment (p<0.001). NPRS scores decreased from 5.93±0.80 to 2.33±0.49 in the experimental group and from 5.93±0.70 to 4.33±0.49 in the control group, with a between-group difference in change of −2.00 points (95% CI: −2.55 to −1.45; p<0.001). Kujala scores improved by 27.87 points in the experimental group compared with 13.60 points in the control group, yielding a between-group difference of 14.27 points (95% CI: 12.60–15.94; p<0.001). Hip abductor strength increased by 4.55 kg versus 1.75 kg, while knee flexion ROM increased by 10.67° versus 4.60° in the experimental and control groups, respectively. Knee extension loss also showed greater improvement in the experimental group.

Conclusion: Hip abductor strengthening combined with patellar taping produced greater improvements in pain, functional ability, hip abductor strength, and knee range of motion than conventional physiotherapy in patients with HFPIS. The findings suggest that combining proximal strengthening with patellar taping may be a useful physiotherapy approach for managing HFPIS. Larger trials with longer follow-up are warranted to establish the durability and generalizability of these findings.