Knee Pain and Functional Scores After Intramedullary Nailing of Tibial Shaft Fractures Using a Suprapatellar Approach

Serbest, Sancar; Tiftikçi, Uğur; Çoban, Mehmet; Çirpar, Meriç; Dağlar, Bülent

doi:10.1097/bot.0000000000001337

Cited by 28 publications

(21 citation statements)

References 25 publications

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“…In the present study, patients in the subperiosteal cocktail injection group felt less pain at the first day after TKA. This result was in line with our assumption above [32]. Cocktails could directly act on the subperiosteal nerves and might bring better analgesia effects.…”

Section: Discussionsupporting

confidence: 91%

A new improvement: subperiosteal cocktail application to effectively reduce pain and blood loss after total knee arthroplasty

Wang

Zhou

2020

J Orthop Surg Res

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Background: Pain and blood loss after total knee arthroplasty (TKA) are unsolved clinical problems. Some studies reported that periarticular cocktail injection can effectively reduce pain and blood loss. However, there was no gold standard about the cocktail ingredient and injection location. More osteotomy and less soft tissue release in TKA with mild deformity; besides, plenty of nerves and blood vessels are contained in the periosteums and bone marrow. In this study, we aimed to detect the clinical results of subperiosteal cocktail application in TKA. Methods: Two groups were included according to the different injection location in our study. In group 1, cocktails were injected into the muscles, tendons, suprapatellar bursa, and subpatellar bursa surrounding knee joint. In group 2, cocktail injection was performed under the periosteum of the distal femur and proximal tibia. Our primary outcomes were visual analogue scale (VAS) and hemoglobin (Hb), and the secondary outcomes were wound healing, infection, deep vein thrombosis (DVT), operation time, and hospitalization. Results: At the first operative day, the mean (standard deviation) VAS score in a state of static was lower in group 2 compared with group 1 (0.98 ± 0.27 in group 1 and 0.86 ± 0.60 in group 2, p < 0.05). In the state of flexion and extension, the mean (standard deviation) VAS was 1.61 ± 0.66 in group 1 and 1.10 ± 0.57 in group 2 (p < 0.05). The mean (standard deviation) blood loss was higher in group 1 than in group 2 at the first postoperative day (440.19 (167.68) ml in group 1 and 333.67 (205.99) ml in group 2, p < 0.05). At the third day after surgery, the mean (standard deviation) blood loss was 686.44 (140.29) ml in group 1 and 609.19 (260.30) ml in group 2, and there was significant difference between these two groups (p < 0.05). Conclusions: We concluded that subperiosteal cocktail injection can significantly reduce pain and blood loss compared with periarticular cocktail injection after TKA.

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Section: Discussionsupporting

confidence: 91%

A new improvement: subperiosteal cocktail application to effectively reduce pain and blood loss after total knee arthroplasty

Wang

Zhou

2020

J Orthop Surg Res

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“…In the majority of the studies, the infrapatellar approach was described [4,[7][8][9]). Six studies reported on the suprapatellar approach [4,5,[7][8][9][79][80][81][82][83] and one on the semi-extended technique [66]. There were 17 randomized trials [7, 9, 19, 23, 26, 30, 48, 49, 52, 54, 57, 59-61, 64, 68, 71] of which five compared different methods for tibial nailing [7,9,26,49,71], 14 prospective studies [5,11,14,28,31,34,37,39,46,55,70,72,73,83] and 45 retrospective studies [4, 8, 12, 13, 15-18, 20-22, 24, 25, 27, 29, 32, 33, 35, 36, 38, 40-45, 47, 50, 51, 53, 56, 58, 62, 63, 66, 67, 69, 74, 76, 78-82, 84].…”

Section: Resultsmentioning

confidence: 99%

“…The Short Form-36 (SF-36)[5,7,9,24,43,48,51,61,67,80,83], SF-12[4], EQ5D[60], and the Nottingham Health Profile[23,60] were used to measure quality of life after tibial nailing. The pooled estimates could only ) for the suprapatellar technique (Fig.6a, b).…”

mentioning

confidence: 99%

Anterior knee pain and functional outcome following different surgical techniques for tibial nailing: a systematic review

Leliveld

Verhofstad

Bodegraven

et al. 2020

Eur J Trauma Emerg Surg

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Purpose The aim of this systematic review was to compare knee pain and function after tibial nail insertion through an infrapatellar, semi-extended and suprapatellar technique. Methods A search was carried out to identify articles with an exact description of the method used for insertion of the tibial nail and description of the outcome parameters (knee pain or function). Data on study design, population, rate and severity of anterior knee pain and function scores were extracted. Pooled rates and scores were calculated. Results 67 studies with 3,499 patients were included. The pooled rate of patients with anterior knee pain was 38% (95% CI 32–44) after nail insertion through an infrapatellar approach and 10% (95% CI 1–26) after insertion through a suprapatellar approach. Pooled analysis was not possible for the semi-extended technique. Knee pain scores as measured by visual analogue score (0–10) ranged from 0.2 (95% CI − 0.1–0.5) for general knee pain to 3.7 (95% CI 1.3–6.1) for pain during kneeling. Pooled estimates for the Lysholm score were 87 points (range 77–97) for the infrapatellar technique and 85 points (range 82–85) for the suprapatellar technique. Iowa Knee scores were 94 (range 86–96) and Anterior Knee Pain Scale scores were 76 (range 75–80) after infrapatellar nail insertion. Discussion Depending on the technique used, the proportion of patients with knee pain after tibial nailing varied between 10 and 38%. The actual measured knee pain scores were, however, surprisingly low. Knee function was good for both the infra- and suprapatellar technique.

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“…In the management of tibial shaft fractures, intramedullary nailing is the treatment of choice. 11 Low percentage of complications like non-union, infection, mal-union, deep venous thrombosis, thermal necrosis and compartment syndrome has been reported following tibial nailing in literature. 12 The most frequent adverse consequence of tibial nailing is chronic anterior knee pain.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Effects of Different Nail Tip Positions on Anterior Knee Pain After Intramedullary Interlocking Nailing for Tibial Shaft Fractures

Hassan

Anwar

Hassan³

et al. 2021

PAFMJ

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Objective: To determine the frequency of anterior knee pain after intramedullary interlocking nailing in tibial shaft fractures and to compare the intensity of anterior knee pain between positive and negative anterior cortex nail groups.Study Design: Quasi-experimental study. Place and Duration of Study: Department of Orthopaedic Surgery, Combined Military Hospital Rawalpindi, from Oct 2018 to Apr 2019. Methodology: 100 cases of tibial shaft fracture were divided into two groups according to anterior cortex nail distance. Patients 18-40 years of age of both genders, closed fractures, Gustilo Andersen I open tibial diaphyseal fractures and nail tip more than 5mm from tibial tuberosity were included. Patients with osteoarthritis, pathological fractures, renal disease, open fracture GA-II & GA-III and knee instability were excluded from the study. Both groups with positive and negative anterior cortex nail distance were compared for pain using the chi-square test. Results: Frequency of anterior knee pain after intramedullary interlocking nailing in tibial shaft fractures was found in 24% of patients. 8 (16%) out of 50 patients in the group with nail tip deep to anterior cortex had anterior knee pain while 16 (32%) out of 50 patients in the group with nail tip protruding from anterior cortex suffered anterior knee pain (p-value = 0.061). Conclusion: Intramedullary interlocking nailing in tibial shaft fractures with nail tip deep to anterior cortex showed less pain as compared to nail tip protruding from anterior cortex although it was not statistically significant.

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Knee Pain and Functional Scores After Intramedullary Nailing of Tibial Shaft Fractures Using a Suprapatellar Approach

Abstract: Objectives: To evaluate the effects of intramedullar nailing of the tibia using a suprapatellar (SP) approach with respect to pain and function of the knee.

Cited by 28 publications

References 25 publications

A new improvement: subperiosteal cocktail application to effectively reduce pain and blood loss after total knee arthroplasty

A new improvement: subperiosteal cocktail application to effectively reduce pain and blood loss after total knee arthroplasty

Anterior knee pain and functional outcome following different surgical techniques for tibial nailing: a systematic review

Comparison of Effects of Different Nail Tip Positions on Anterior Knee Pain After Intramedullary Interlocking Nailing for Tibial Shaft Fractures

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