title: Knee pain correlates with union after tibial nailing.
abstract: OBJECTIVE
  The purpose of this study is to evaluate the change in quantitatively scored knee pain during union.
  
  
  METHODS
  This is a retrospective review of prospectively collected data over a 15-year period.
  
  
  METHODS
  Academic medical center.
  
  
  METHODS
  All patients treated with an intramedullary nail were evaluated for knee pain and union. Four hundred twenty-eight patients with 443 tibia fractures were included.
  
  
  METHODS
  All tibia fractures were treated with an intramedullary nail.
  
  
  RESULTS
  Patient-based knee pain was scored from 0 to 3. Fracture union was also graded using a modified Hammer score based on cortical bridging and remodeling.
  
  
  RESULTS
  We found a significant inverse association between pain and union score (P < 0.01). In contradistinction, there was not a correlation between time from surgery and pain (P = 0.13). Because union score and time were related, a model was created with both parameters. This model demonstrated a statistical correlation with union score (P < 0.01), but not for time from surgery (P = 0.18).
  
  
  CONCLUSIONS
  We postulated that knee pain may correlate with either union or time from surgery. We found a statistically significant, negative correlation between knee pain and fracture union. There was no such association between pain and time from surgery.
authors: Boston University Medical Center, Department of Orthopaedic Surgery, Boston, MA 02118, USA.
authors: Scott P
authors: SP
authors: Ryan
authors: Paul
authors: P
authors: Tornetta
authors: Cassandra
authors: C
authors: Dielwart
authors: Elizabeth
authors: E
authors: Kaye-Krall
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails; D016723:Bone Remodeling / Q000502:physiology; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation* / Q000379:methods; D017102:Fracture Healing / Q000502:physiology*; D006784:Hospitals, Teaching; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology* / Q000503:physiopathology; D012189:Retrospective Studies; D013978:Tibial Fractures / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D016474:Weight-Bearing; D055815:Young Adult