title: Knee pain after intramedullary tibial nailing: its incidence, etiology, and outcome.
abstract: OBJECTIVE
  To establish the incidence and clinical effects of anterior knee pain after intramedullary nailing of the tibia.
  
  
  METHODS
  A retrospective study.
  
  
  METHODS
  The Royal Infirmary of Edinburgh, Scotland.
  
  
  METHODS
  169 patients who presented with a tibial diaphyseal fracture and were treated by intramedullary nailing.
  
  
  METHODS
  All patients were treated with a reamed Grosse Kempf tibial nail.
  
  
  METHODS
  Anterior knee pain was assessed with an analogue scale and functional outcome was examined using a series of routine daily activities.
  
  
  RESULTS
  Anterior knee pain was found in 56.2% of patients. The only distinguishing feature between patients with and without pain was that the patients who had pain were significantly younger. Most patients had mild pain but there was considerable functional impairment with 91.8% of patients experiencing pain on kneeling and 33.7% having pain even at rest. Nail removal resolved or improved the symptoms in almost all cases.
  
  
  CONCLUSIONS
  Anterior knee pain is a significant complication of intramedullary nailing of the tibia.
authors.affiliation: Edinburgh Orthopaedic Trauma Unit, Royal Infirmary of Edinburgh, Scotland.
authors.forename: C M
authors.initials: CM
authors.lastname: Court-Brown
authors.forename: T
authors.initials: T
authors.lastname: Gustilo
authors.forename: A D
authors.initials: AD
authors.lastname: Shaw
mesh_terms: D000328:Adult; D001858:Bone Nails / Q000009:adverse effects*; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000009:adverse effects* / Q000295:instrumentation; D006801:Humans; D015994:Incidence; D007719:Knee Joint; D008297:Male; D010147:Pain Measurement; D010149:Postoperative Pain / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D011379:Prognosis; D012189:Retrospective Studies; D013978:Tibial Fractures / Q000601:surgery*