126 patients with symptomatic, Kellgren-Lawrence grade II-III, patellofemoral osteoarthritis were randomized to treatment with or without a patellofemoral brace for 6 weeks. The purpose of this study was to compare outcomes of pain during activity, function, and MRI-assessed bone marrow lesion volume at 6 weeks. The results demonstrated a significantly lower visual analog scale (VAS) pain during activity and a higher score for activities of daily living on the Knee Injury and Osteoarthritis Outcome Score (KOOS) in the brace group compared to control group. Patellofemoral bone marrow lesion volume after 6 weeks was significantly lower in the brace group compared to control group, while there was no significant difference in tibiofemoral bone marrow lesion volume between groups at 6 weeks.