Influence of sagittal plane malpositioning of the patella on anterior knee pain after tibia intramedullary nailing

Türkmen, İsmail; Sağlam, Yavuz; Türkmensoy, Fatih; Kemah, Bahattin; Kara, Adnan; Unay, Koray

doi:10.1007/s00590-016-1856-x

Cited by 8 publications

(9 citation statements)

References 19 publications

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“…However, due to initial posttraumatic pain at the fracture side this might not have been possible in any case. Furthermore, compared to Turkmen et al we did observe worse subjective function and knee pain in patients with patella baja [12]. One reason might be the measured score.…”

Section: Discussioncontrasting

confidence: 55%

“…Although, intramedullary nailing is a well-established and successful treatment option for patients with tibial shaft fractures a high complication rate of 10-80% of the patients who suffer anterior knee pain is described [3][4][5][6]. Several reasons for anterior knee pain have been described and one major reason is the iatrogenic soft tissue damage with potential painful scarring resulting in a shortening of the patellar tendon [12]. Turkmen et al could show that a shorter patellar tendon can be observed in patients after intramedullary nailing on the operated side, compared to the non-operated side [12].…”

Section: Discussionmentioning

confidence: 99%

“…By dividing both distances the ISI was determined. The presence of PB was defined as ISI < 0.8 [ 9 , 10 , 12 , 13 ]. Nail tip position was measured.…”

Section: Methodsmentioning

confidence: 99%

“…However, we know from various studies on knee arthroplasty that a not inconsiderable part of anterior knee pain is caused, by access morbidity and the development of a PB [ 11 ]. Focusing back on patients with intramedullary nailing at the knee, only limited data exist reporting a development of PB in a case of retrograde nailing of the femur and one study after IM nailing of the tibia [ 10 , 12 ]. Although the second study, including 33 patients after tibial nailing, observed a development of postoperative PB compared to the healthy side, no difference in anterior knee pain could be observed [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

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Patella baja after intramedullary nailing of tibial fractures, using an infrapatellar/transtendinous approach, predicts worse patient reported outcome

Graulich

Gerhardy

Pacha

et al. 2021

Eur J Trauma Emerg Surg

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Purpose After intramedullary nailing of tibial shaft fractures using an infrapatellar/transtendinous approach, several patients suffer anterior knee pain. We suspect that the approach is associated with soft tissue scars and the development of a postoperative patella baja. The goal of the study is to investigate whether the development of patella baja is associated with worse subjective outcomes. Methods We retrospectively analyzed all patients in our orthopedic trauma department between 2011 and 2020 who underwent tibial fracture fixation via intramedullary nailing via an infrapatellar/transtendinous approach. Pre- and postoperative lateral knee x-rays were evaluated by measurement of the Insall-Salvati Index, and nail tip position. All patients were asked to answer the self-assessment Kujala questionnaire and Lysholm questionnaire. Results We included 78 patients (age: 44 ± 18 years) with a minimum follow-up of 12 months. Mean follow up was 59 ± 25 months. We included 50 male and 28 female patients. Patella baja detected by Insall-Salvati Index could be observed in 8 (10.3%) patients. Patients with patella baja showed significant worse function measured by the Kujala score 54 ± 18 vs. 80 ± 14 (p < 0.01). Likewise, Lysholm score did show significant differences between both groups (60 ± 24 vs. 86 ± 11; p < 0.01). Nail tip position was not associated with worse subjective function. Conclusions Patella baja in patients after tibial intramedullary nailing via an infrapatellar/transtendinous approach, is associated with worse subjective function and increased pain.

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Section: Discussioncontrasting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

“…By dividing both distances the ISI was determined. The presence of PB was defined as ISI < 0.8 [ 9 , 10 , 12 , 13 ]. Nail tip position was measured.…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Patella baja after intramedullary nailing of tibial fractures, using an infrapatellar/transtendinous approach, predicts worse patient reported outcome

Graulich

Gerhardy

Pacha

et al. 2021

Eur J Trauma Emerg Surg

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“…Poor outcomes result in recurrence, infection and other complications, of which knee pain is the most common. [39] A recent related study by Lee pointed out that surgical treatment is suitable for both acute and recurrent patellar dislocations, [4,40] and that it can improve knee joint function. [9] More importantly, patients often have a low recurrence rate after surgical treatment.…”

Section: Discussionmentioning

confidence: 99%

Surgical versus nonsurgical treatment of primary acute patellar dislocation

et al. 2019

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Background: To systematically review the efficacy of surgical versus nonsurgical treatment for acute patellar dislocation. Materials and Methods: PubMed, Cochrane, and Embase were searched up to February 12, 2019. After removing duplicates, preliminary screening, and reading the full texts, we finally selected 16 articles, including 11 randomized controlled trials and 5 cohort studies. The quality of the enrolled studies was evaluated by Jadad score or Newcastle–Ottawa scale. Meta-analyses were performed using odds ratio (OR) and standardized mean difference (SMD) as effect variables. The clinical parameters assessed included mean Kujala score, rate of redislocation, incidence of patellar subluxation, patient satisfaction, and visual analog scale (VAS) for pain. Evidence levels were determined using GRADE profile. Results: The 16 included studies involved 918 cases, 418 in the surgical group and 500 in the nonsurgical group. The results of the meta-analysis showed higher mean Kujala score (SMD = 0.79, 95% confidence interval [CI] [0.3, 1.28], P = .002) and lower rate of redislocation (OR = 0.44, 95% CI [0.3, 0.63], P < .00001) in the surgical group than the nonsurgical group, but showed insignificant differences in the incidence of patellar subluxation (OR = 0.61, 95% CI [0.36, 1.03], P = .06), satisfaction of patients (OR = 1.44, 95% CI [0.64, 3.25], P = .38), and VAS (SMD = 0.84, 95% CI [−0.36, 9.03], P = .84). Conclusion: For patients with primary acute patellar dislocation, surgical treatment produces a higher mean Kujala score and a lower rate of redislocation than nonsurgical treatment.

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Comparison of three different approaches for anterior knee pain after tibia intramedullary nailing

Özcan

Türkmen

Sökücü

2018

Eur J Trauma Emerg Surg

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Influence of sagittal plane malpositioning of the patella on anterior knee pain after tibia intramedullary nailing

Abstract: Level 3 (Case control study).

Cited by 8 publications

References 19 publications

Patella baja after intramedullary nailing of tibial fractures, using an infrapatellar/transtendinous approach, predicts worse patient reported outcome

Patella baja after intramedullary nailing of tibial fractures, using an infrapatellar/transtendinous approach, predicts worse patient reported outcome

Surgical versus nonsurgical treatment of primary acute patellar dislocation

Comparison of three different approaches for anterior knee pain after tibia intramedullary nailing

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