86.
Anterior Knee Pain and Limitations in Activity and Participation after
Intramedullary Nailing of Tibial Shaft Fracture
Peter Larsen, Hans Lund, Uffe Laessoe, Thomas Graven-Nielsen, Juozas
Petruskevicius, Sten Rasmussen
Department of Occupational Therapy and Physiotherapy Aalborg Hospital,
Aarhus University, Denmark; Research Unit for Musculoskeletal Function and
Physiotherapy, Institute for Sports Science and Clinical Biomechanics,
University of Southern Denmark; Physiotherapy Department & Laboratory for
Musculoskeletal Pain and Motor Control, Center for Sensory, UCN, Denmark
&
Faculty of Medicine, Aalborg University, Denmark; Laboratory for
Musculoskeletal Pain and Motor Control, Center for Sensory-Motor
Interaction (SMI), D, Faculty of Medicine, Aalborg University, Denmark;
Department of Orthopaedic Surgery, Aalborg Hospital, Aarhus University,
Denmark; Orthopaedic Surgery Research Unit, Research and Innovation
Center, Faculty of Medicine, Aarhus University, Aalborg Hospital
Background:
Anterior knee pain is commonly reported after intramedullary
nailing of a tibial shaft fracture. Complications such as limitations in activity
and participation, and restriction in quality of life are often ignored.
Purpose / Aim of Study:
The objective of the present study was to evaluate
long-term outcome of anterior knee pain, limitations in activity and
participation, and quality of life for patients treated with intramedullary nailing
of tibial shaft fracture.
Materials and Methods:
This retrospective follow-up study included patients
treated with intramedullary nailing after tibia shaft fracture from 1998-2008 at
Aalborg Hospital, University of Aarhus (N=294). Participants completed the
Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire and
these data were compared with published reference data. The KOOS data were
analyzed in 5 subscales (Pain, Symptoms, ADL, Sport, QOL) and 4 age-
groups.
Findings / Results:
A total of 223 agreed to participate (76%) and mean time
for follow-up was 7.9 ± 3.2 years. The mean KOOS within subscales was: Pain
82.9
± 20.5, ADL 83.3 ± 20.9, Symptoms 84.1 ± 17.3 QOL 66.3 ± 28.4 and
Sport 59.1 ± 32.7. Compared with reference data the scores within Pain, Sport,
QOL and ADL were worse. In study population ANOVA test between KOOS
subscales and age groups showed difference between groups for Pain
(
P<0.019), ADL (P<0.032), QOL (P<0.032), and Sport (P<0.047). The age
group between 18-34 years reported worse KOOS-scores than all older age
groups.
Conclusions:
Approximately 8 years after intramedullary nailing of tibial shaft
fracture the majority of patients experienced anterior knee pain, impairments,
limitation in activity, and restrictions in QOL compared with a reference
population. Moreover this was mainly expressed in the young patients.
