Knee Pain After Intramedullary Nailing in the Tibia

NCT03649360 | Completed

• 1 other identifier: IMN Study
• Study Type: observational
• Target: 223
• Locations: 1 country
• Sites: 1

Brief Summary

The primary objective of this study is to evaluate the long-term outcome after inserting an intramedullary nail in patients with a tibial shaft fracture using an injury-specific questionnaire.

Conditions

Tibia Fracture; Knee Pain Chronic

Keywords

Knee pain; Intramedullary tibial nail; KOOS

Outcome Measures

Primary Outcomes (1)

• Knee Pain after Tibial Shaft Fracture Treated with Intramedullary Nailing

  The primary objective of this study is to evaluate the long-term outcome after inserting an IMN in patients with a tibial shaft fracture using an injury-specific questionnaire. We used the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire to collect patient data. It is used to assess patient's subjective opinion about symptoms related to the knee and other associated problems. The questionnaire has been translated and validated in Danish and consists of 5 subscales: pain, symptoms, function in daily living (ADL) function in sports and recreation and knee-related QOL. Each subscale has between 4 and 17 questions (a total of 42 questions) with each question having 5 options ranging from no symptoms to severe symptoms. Each question gets a score from 0-4 and a score from 0-100 is calculated. 100 indicating no symptoms and 0 indicates major symptoms.

  1st of November 2009 till 30th of October 2014.

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

All patients who underwent surgery with reamed, locked intramedullary nailing after isolated tibial shaft fracture at one of the above mentioned orthopedic departments between 1st of November 2009 and 30th of October 2014 were sought.

You may qualify if:

• Patients aged 18 years or older, alive and residing in Denmark at the time of follow-up could be included in the study.

You may not qualify if:

• Patients who were unable to fill out the questionnaire due to concomitant physical condition or who had undergone amputation or further surgery on the affected limb were excluded.

Sponsors & Collaborators

• Copenhagen University Hospital, Hvidovre: lead

Study Sites (1)

Copenhagen University Hospital of Hvidovre

Hvidovre, 2650, Denmark

Location

Related Publications (23)

• Bone LB, Johnson KD. Treatment of tibial fractures by reaming and intramedullary nailing. J Bone Joint Surg Am. 1986 Jul;68(6):877-87.

  PMID: 3733776 BACKGROUND

• Bone LB, Sucato D, Stegemann PM, Rohrbacher BJ. Displaced isolated fractures of the tibial shaft treated with either a cast or intramedullary nailing. An outcome analysis of matched pairs of patients. J Bone Joint Surg Am. 1997 Sep;79(9):1336-41. doi: 10.2106/00004623-199709000-00007.

  PMID: 9314395 BACKGROUND

• Court-Brown CM, Gustilo T, Shaw AD. Knee pain after intramedullary tibial nailing: its incidence, etiology, and outcome. J Orthop Trauma. 1997 Feb-Mar;11(2):103-5. doi: 10.1097/00005131-199702000-00006.

  PMID: 9057144 BACKGROUND

• Hiesterman TG, Shafiq BX, Cole PA. Intramedullary nailing of extra-articular proximal tibia fractures. J Am Acad Orthop Surg. 2011 Nov;19(11):690-700. doi: 10.5435/00124635-201111000-00005.

  PMID: 22052645 BACKGROUND

• Lefaivre KA, Guy P, Chan H, Blachut PA. Long-term follow-up of tibial shaft fractures treated with intramedullary nailing. J Orthop Trauma. 2008 Sep;22(8):525-9. doi: 10.1097/BOT.0b013e318180e646.

  PMID: 18758282 BACKGROUND

• Toivanen JA, Vaisto O, Kannus P, Latvala K, Honkonen SE, Jarvinen MJ. Anterior knee pain after intramedullary nailing of fractures of the tibial shaft. A prospective, randomized study comparing two different nail-insertion techniques. J Bone Joint Surg Am. 2002 Apr;84(4):580-5. doi: 10.2106/00004623-200204000-00011.

  PMID: 11940618 BACKGROUND

• Karladani AH, Granhed H, Edshage B, Jerre R, Styf J. Displaced tibial shaft fractures: a prospective randomized study of closed intramedullary nailing versus cast treatment in 53 patients. Acta Orthop Scand. 2000 Apr;71(2):160-7. doi: 10.1080/000164700317413139.

  PMID: 10852322 BACKGROUND

• Morandi M, Banka T, Gaiarsa GP, Guthrie ST, Khalil J, Hoegler J, Lindeque BG. Intramedullary nailing of tibial fractures: review of surgical techniques and description of a percutaneous lateral suprapatellar approach. Orthopedics. 2010 Mar;33(3):172-9. doi: 10.3928/01477447-20100129-22. No abstract available.

  PMID: 20205366 BACKGROUND

• Karachalios T, Babis G, Tsarouchas J, Sapkas G, Pantazopoulos T. The clinical performance of a small diameter tibial nailing system with a mechanical distal aiming device. Injury. 2000 Jul;31(6):451-9. doi: 10.1016/s0020-1383(00)00024-3.

  PMID: 10831746 BACKGROUND

• Katsoulis E, Court-Brown C, Giannoudis PV. Incidence and aetiology of anterior knee pain after intramedullary nailing of the femur and tibia. J Bone Joint Surg Br. 2006 May;88(5):576-80. doi: 10.1302/0301-620X.88B5.16875. No abstract available.

  PMID: 16645100 BACKGROUND

• Vaisto O, Toivanen J, Kannus P, Jarvinen M. Anterior knee pain after intramedullary nailing of fractures of the tibial shaft: an eight-year follow-up of a prospective, randomized study comparing two different nail-insertion techniques. J Trauma. 2008 Jun;64(6):1511-6. doi: 10.1097/TA.0b013e318031cd27.

  PMID: 18545115 BACKGROUND

• Althausen PL, Neiman R, Finkemeier CG, Olson SA. Incision placement for intramedullary tibial nailing: an anatomic study. J Orthop Trauma. 2002 Nov-Dec;16(10):687-90. doi: 10.1097/00005131-200211000-00001.

  PMID: 12439190 BACKGROUND

• Weninger P, Schultz A, Traxler H, Firbas W, Hertz H. Anatomical assessment of the Hoffa fat pad during insertion of a tibial intramedullary nail--comparison of three surgical approaches. J Trauma. 2009 Apr;66(4):1140-5. doi: 10.1097/TA.0b013e318169cd4d.

  PMID: 19359927 BACKGROUND

• Hernigou P, Cohen D. Proximal entry for intramedullary nailing of the tibia. The risk of unrecognised articular damage. J Bone Joint Surg Br. 2000 Jan;82(1):33-41. doi: 10.1302/0301-620x.82b1.9818.

  PMID: 10697311 BACKGROUND

• Orfaly R, Keating JE, O'Brien PJ. Knee pain after tibial nailing: does the entry point matter? J Bone Joint Surg Br. 1995 Nov;77(6):976-7. No abstract available.

  PMID: 7593119 BACKGROUND

• Bhattacharyya T, Seng K, Nassif NA, Freedman I. Knee pain after tibial nailing: the role of nail prominence. Clin Orthop Relat Res. 2006 Aug;449:303-7. doi: 10.1097/01.blo.0000223976.91089.08.

  PMID: 16702914 BACKGROUND

• Ryan SP, Tornetta P 3rd, Dielwart C, Kaye-Krall E. Knee pain correlates with union after tibial nailing. J Orthop Trauma. 2011 Dec;25(12):731-5. doi: 10.1097/BOT.0b013e318213f587.

  PMID: 21886000 BACKGROUND

• Demirtas A, Azboy I, Durakbasa MO, Ucar BY, Mercan AS, Cakir IA. [The relationship between the quadriceps muscle strength and the anterior knee pain occurring after locked intramedullary nailing for tibial diaphysis fractures]. Eklem Hastalik Cerrahisi. 2011 Aug;22(2):81-4. Turkish.

  PMID: 21762062 BACKGROUND

• Vaisto O, Toivanen J, Kannus P, Jarvinen M. Anterior knee pain and thigh muscle strength after intramedullary nailing of a tibial shaft fracture: an 8-year follow-up of 28 consecutive cases. J Orthop Trauma. 2007 Mar;21(3):165-71. doi: 10.1097/BOT.0b013e31803773cd.

  PMID: 17473752 BACKGROUND

• Weller S, Kuner E, Schweikert CH. Medullary nailing according to Swiss study group principles. Clin Orthop Relat Res. 1979 Jan-Feb;(138):45-55.

  PMID: 445918 BACKGROUND

• Lottes JO. Medullary nailing of the tibia with the triflange nail. Clin Orthop Relat Res. 1974 Nov-Dec;(105):53-66. No abstract available.

  PMID: 4609657 BACKGROUND

• Paradowski PT, Bergman S, Sunden-Lundius A, Lohmander LS, Roos EM. Knee complaints vary with age and gender in the adult population. Population-based reference data for the Knee injury and Osteoarthritis Outcome Score (KOOS). BMC Musculoskelet Disord. 2006 May 2;7:38. doi: 10.1186/1471-2474-7-38.

  PMID: 16670005 BACKGROUND

• Erin-Madsen N, Aasvang TK, Viberg B, Bloch T, Brix M, Tengberg PT. Knee pain and associated complications after intramedullary nailing of tibial shaft fracture. Dan Med J. 2019 Aug;66(8):A5554.

  PMID: 31315794 DERIVED

Related Links

• KOOS questionnaire \[KOOS web site\]. Accessed May 20th 2015.
• Danish Database of Fractures website. Accessed March 25, 2015.

MeSH Terms

Conditions

Tibial Fractures

Condition Hierarchy (Ancestors)

Fractures, Bone; Wounds and Injuries; Leg Injuries

Study Officials

• Nikolaj Erin-Madsen, MD

  Copenhagen University Hospital of Hvidovre

  STUDY DIRECTOR

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: August 23, 2018
• First Posted: August 28, 2018
• Study Start: November 1, 2009
• Primary Completion: October 31, 2014
• Study Completion: December 15, 2016
• Last Updated: August 28, 2018

Record last verified: 2018-08

Data Sharing

• IPD Sharing: Will not share

Locations

DK (1)