title: One-year postoperative knee pain in patients with semi-extended tibial nailing versus control group.
abstract: The purpose of this study was to determine whether patients with a tibia fracture who were treated with an intramedullary nail using a semi-extended, extra-articular, parapatellar approach had anterior knee pain at a higher than acceptable incidence compared with control patients. Eighteen patients with OTA type 42 A-C tibia fractures nailed using this approach were compared with an uninjured control group (n = 22). Lysholm Knee Score questionnaires were given to all participants and compared between groups. Fracture patients completed the LKS at 6 months and 1 year postoperatively. Additional data collected included age, sex, mechanism of injury, OTA classification, Gustilo/Anderson and Tscherne classification, nail-apex distance, complications, weight-bearing status, additional fixation needed, and postoperative procedures. Mean age and demographics were similar between the fracture and control group: 42.9 vs 47.9 years, respectively, (P=.36) and 11 vs 9 men, respectively (P=.11). Lysholm Knee Scores among the subgroups (age, sex, medial vs lateral parapatellar approach, soft-tissue status, and nail-apex distance) showed no statistically significant differences (P>05 for all comparisons). Mean nail-apex distance was -16.3 mm. Mean LKS score 1-year postoperatively was 87.3 (range, 59-100) in the fracture group and 89.7 (range, 23-100) in the control group (P=.69). At 1-year postoperatively, patients in the fracture group did not have increased anterior knee pain compared with the control group.
authors.affiliation: Department of Orthopaedics, DLR, University of California at Davis, Sacramento, California 95817, USA. davidlrothberg@gmail.com
authors.forename: David L
authors.initials: DL
authors.lastname: Rothberg
authors.forename: Gregory M
authors.initials: GM
authors.lastname: Daubs
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Horwitz
authors.forename: Erik N
authors.initials: EN
authors.lastname: Kubiak
mesh_terms: D000328:Adult; D018771:Arthralgia / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000009:adverse effects*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis* / Q000209:etiology*; D013978:Tibial Fractures / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome