Character, Incidence, and Predictors of Knee Pain and Activity After Infrapatellar Intramedullary Nailing of an Isolated Tibia Fracture

J Orthop Trauma. 2016 Mar;30(3):135-41. doi: 10.1097/BOT.0000000000000475.

Abstract

Objective: To study the activity and incidence of knee pain after sustaining an isolated tibia fracture treated with an infrapatellar intramedullary nail at 1 year.

Design: Retrospective review of prospective cohort.

Setting: Multicenter Academic and Community hospitals.

Patients: Four hundred thirty-seven patients with an isolated tibia fracture completed a 12-month assessment on pain and self-reported activity.

Intervention: Infrapatellar intramedullary nail.

Outcomes: Demographic information, comorbid conditions, injury characteristics, and surgical technique were recorded. Knee pain was defined on a 1-7 scale with 1 being "no pain" and 7 being a "very great deal of pain." Knee pain >4 was considered clinically significant. Patients reported if they were "able," "able with difficulty," or "unable" to perform the following activities: kneel, run, climb stairs, and walk prolonged. Variables were tested in multilevel multivariable regression analyses.

Results: In knee pain, 11% of patients reported a "good deal" to a "very great deal" of pain (>4), and 52% of patients reported "no" or "very little" pain at 12 months. In activity at 12 months, 26% and 29% of patients were unable to kneel or run, respectively, and 31% and 35% of patients, respectively, stated they were able with difficulty or unable to use stairs or walk.

Conclusions: Clinically significant knee pain (>4/7) was present in 11% of patients 1 year after a tibia fracture. Of note, 31%-71% of patients had difficulty performing or were unable to perform routine daily activities of kneeling, running, and stair climbing, or walking prolonged distances.

Level of evidence: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Arthralgia / diagnosis
  • Arthralgia / epidemiology*
  • Arthralgia / prevention & control
  • Canada / epidemiology
  • Causality
  • Cohort Studies
  • Comorbidity
  • Female
  • Fracture Fixation, Intramedullary / statistics & numerical data*
  • Humans
  • Incidence
  • Knee Joint*
  • Male
  • Netherlands / epidemiology
  • Pain, Postoperative / diagnosis
  • Pain, Postoperative / epidemiology*
  • Pain, Postoperative / prevention & control
  • Patella / surgery
  • Retrospective Studies
  • Risk Factors
  • Tibial Fractures / diagnosis
  • Tibial Fractures / epidemiology*
  • Tibial Fractures / surgery*
  • Treatment Outcome
  • United States / epidemiology