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

William Obremskey, Julie Agel, Kristin Archer, Philip To, Paul Tornetta, Mohit Bhandari, Gordon Guyatt, David W. Sanders, Emil H. Schemitsch, Marc Swiontkowski, Stephen Walter, Sheila Sprague, Diane Heels-Ansdell, Lisa Buckingham, Pamela Leece, Helena Viveiros, Tashay Mignott, Natalie Ansell, Natalie Sidorkewicz, Claire BombardierJesse A. Berlin, Michael Bosse, Bruce Browner, Brenda Gillespie, Alan Jones, Peter O'Brien, Rudolf Poolman, Mark D. Macleod, Timothy Carey, Kellie Leitch, Stuart Bailey, Kevin Gurr, Ken Konito, Charlene Bartha, Isolina Low, Leila V. MacBean, Mala Ramu, Susan Reiber, Ruth Strapp, Christina Tieszer, Hans J. Kreder, David J G Stephen, Terry S. Axelrod, Albert J M Yee, Robin R. Richards, Joel Finkelstein, Wade Gofton, John Murnaghan, Joseph Schatztker, Michael Ford, Beverly Bulmer, Lisa Conlan, G. Yves Laflamme, Gregory Berry, Pierre Beaumont, Pierre Ranger, Georges Henri Laflamme, Sylvain Gagnon, Michel Malo, Julio Fernandes, Marie France Poirier, Michael D. McKee, James P. Waddell, Earl R. Bogoch, Timothy R. Daniels, Robert R. McBroom, Milena R. Vicente, Wendy Storey, Lisa M. Wild, Robert McCormack, Bertrand Perey, Thomas J. Goetz, Graham Pate, Murray J. Penner, Kostas Panagiotopoulos, Shafique Pirani, Ian G. Dommisse, Richard L. Loomer, Trevor Stone, Karyn Moon, Mauri Zomar, Lawrence X. Webb, Robert D. Teasdall, John Peter Birkedal, David Franklin Martin, David S. Ruch, Douglas J. Kilgus, David C. Pollock, Mitchel Brion Harris, Ethan Ron Wiesler, William G. Ward, Jeffrey Scott Shilt, Andrew L. Koman, Gary G. Poehling, Brenda Kulp, William R. Creevy, Andrew B. Stein, Christopher T. Bono, Thomas A. Einhorn, T. Desmond Brown, Donna Pacicca, John B. Sledge, Timothy E. Foster, Ilva Voloshin, Jill Bolton, Hope Carlisle, Lisa Shaughnessy, William T. Obremskey, C. Michael LeCroy, Eric G. Meinberg, Terry M. Messer, William L. Craig, Douglas R. Dirschl, Robert Caudle, Tim Harris, Kurt Elhert, William Hage, Robert Jones, Luis Piedrahita, Paul O. Schricker, Robin Driver, Jean Godwin, Philip James Kregor, Gregory Tennent, Lisa M. Truchan, Marcus Sciadini, Franklin D. Shuler, Robin E. Driver, Mary Alice Nading, Jacky Neiderstadt, Alexander R. Vap, Heather A. Vallier, Brendan M. Patterson, John H. Wilber, Roger G. Wilber, John K. Sontich, Timothy Alan Moore, Drew Brady, Daniel R. Cooperman, John A. Davis, Beth Ann Cureton, Scott Mandel, R. Douglas Orr, John T S Sadler, Tousief Hussain, Krishan Rajaratnam, Bradley Petrisor, Brian Drew, Drew A. Bednar, Desmond C H Kwok, Shirley Pettit, Jill Hancock, Peter A. Cole, Joel J. Smith, Gregory A. Brown, Thomas A. Lange, John G. Stark, Bruce A. Levy, Marc F. Swiontkowski, Mary J. Garaghty, Joshua G. Salzman, Carol A. Schutte, Linda Tastad, Sandy Vang, David Seligson, Craig S. Roberts, Arthur L. Malkani, Laura Sanders, Carmen Dyer, Jessica Heinsen, Langan Smith, Sudhakar Madanagopal, Linda Frantz-Bush, Kevin J. Coupe, Jeffrey J. Tucker, Allen R. Criswell, Rosemary Buckle, Alan Jeffrey Rechter, Dhiren Shaskikant Sheth, Brad Urquart, Thea Trotscher, Mark J. Anders, Joseph M. Kowalski, Marc S. Fineberg, Lawrence B. Bone, Matthew J. Phillips, Bernard Rohrbacher, Philip Stegemann, William M. Mihalko, Cathy Buyea, Stephen J. Augustine, William Thomas Jackson, Gregory Solis, Sunday U. Ero, Daniel N. Segina, Hudson B. Berrey, Samuel G. Agnew, Michael Fitzpatrick, Lakina C. Campbell, Lynn Derting, June McAdams, J. Carel Goslings, Kees Jan Ponsen, Jan Luitse, Peter Kloen, Pieter Joosse, Jasper Winkelhagen, Raphaël Duivenvoorden, David C. Teague, Joseph Davey, J. Andy Sullivan, William J J Ertl, Timothy A. Puckett, Charles B. Pasque, John F. Tompkins, Curtis R. Gruel, Paul Kammerlocher, Thomas P. Lehman, William R. Puffinbarger, Kathy L. Carl, Donald W. Weber, Nadr M. Jomha, Gordon R. Goplen, Edward Masson, Lauren A. Beaupre, Karen E. Greaves, Lori N. Schaump, Kyle J. Jeray, David R. Goetz, David E. Westberry, J. Scott Broderick, Bryan S. Moon, Stephanie L. Tanner, James N. Powell, Richard E. Buckley, Leslie Elves, Stephen Connolly, Edward P. Abraham, Trudy Steele, Thomas Ellis, Alex Herzberg, George A. Brown, Dennis E. Crawford, Robert Hart, James Hayden, Robert M. Orfaly, Theodore Vigland, Maharani Vivekaraj, Gina L. Bundy, Theodore Miclau, Amir Matityahu, R. Richard Coughlin, Utku Kandemir, R. Trigg McClellan, Cindy Hsin Hua Lin, David Karges, Kathryn Cramer, J. Tracy Watson, Berton Moed, Barbara Scott, Dennis J. Beck, Carolyn Orth, David Puskas, Russell Clark, Jennifer Jones, Kenneth A. Egol, Nader Paksima, Monet France, Eugene K. Wai, Garth Johnson, Ross Wilkinson, Adam T. Gruszczynski, Liisa Vexler

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)135-141
Number of pages7
JournalJournal of Orthopaedic Trauma
Volume30
Issue number3
DOIs
StatePublished - Mar 1 2016
Externally publishedYes

    Fingerprint

Keywords

  • functional outcome
  • intramedullary nail
  • knee pain
  • tibia fracture

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Obremskey, W., Agel, J., Archer, K., To, P., Tornetta, P., Bhandari, M., Guyatt, G., Sanders, D. W., Schemitsch, E. H., Swiontkowski, M., Walter, S., Sprague, S., Heels-Ansdell, D., Buckingham, L., Leece, P., Viveiros, H., Mignott, T., Ansell, N., Sidorkewicz, N., ... Vexler, L. (2016). Character, Incidence, and Predictors of Knee Pain and Activity after Infrapatellar Intramedullary Nailing of an Isolated Tibia Fracture. Journal of Orthopaedic Trauma, 30(3), 135-141. https://doi.org/10.1097/BOT.0000000000000475