Anterior knee pain is a common complaint of patient s who have received a tibial intramedullary nail for treatment of a tibia fracture. Proposed reasons for anterior knee pain include nail prominence, insertion site and placement of the skin incision and approach for insertion relative to the patellar tendon. This study will compare the incidence of anterior knee pain associated with different approaches for insertion of an intramedullary nail for tibia fractures. A semi-extended parapatellar approach, with the nail inserted with the knee in relative extension, will be compared to traditional approaches that require nail insertion with the knee in flexion. Randomization envelopes will be created using a randomly generated list. Envelopes will be provided to surgeons after a patient consents to participate.
The research begins when the patient is asked to join the study prior to operative treatment of their tibia fracture. Patients will be asked to complete the IKDC Subjective Knee Evaluation form at their standard-of-care 6mo and 1yr follow-up clinic visits to assess the amount of anterior knee pain the patient is experiencing and the PROMIS Physical Function CAT to assess physical function post-operatively. At the patient's election, the survey may be completed during their standard-of-care follow-up visit to the clinic or sent to them via mail and/or email. Scores will be compared among the two groups to assess differences in anterior knee pain. Conclusions will be drawn regarding the efficacy of the semi-extended parapatellar approach for tibial nailing in regards to anterior knee pain.
Principal Investigator: David Rothberg
Department: Orthopedic Surgery Operations