Objectives: To assess if a suprapatellar (SP) approach, when compared with an infrapatellar (IP) approach, yielded less patient-reported anterior knee pain and higher patellofemoral joint function at 6 weeks and 12 months postoperatively, when treating tibial fractures with intramedullary nailing.
Design: Prospective, parallel-group randomized control trial.
Setting: Tertiary level 1 trauma care center, Brisbane, Australia.
Patients Selection Criteria: Skeletally mature patients with an acute diaphyseal tibial fracture (AO/OTA 41A2/3, 42 A1-43A3) amenable to an intramedullary nailing were included. Exclusion criteria were periprosthetic fractures, nonunions, and presence of a contralateral injury that would restrict weight-bearing.
Outcome Measures And Comparisons: Anterior knee pain through the visual analog scale (VAS) and patellofemoral function using the Kujala scale at 6 weeks and 12 months were compared between those treated with a SP and IP approach.
Results: Ninety-five tibia fractures were included in the randomized trial, with complete follow-up data for 44 and 46 tibia fractures in the SP and IP groups, respectively. The SP cohort exhibited better patellofemoral knee function at both 6 weeks (Kajula 53.0 for SP vs. 43.2 for IP, P < 0.01) and 12 months (Kujala 92.0 for SP vs. 81.3 for IP, P < 0.01) postoperatively and a reduction in anterior knee pain at 12 months postoperatively (VAS 0.7 SP vs. 2.9 IP, P < 0.01).
Conclusions: This randomized trial demonstrated clinically meaningful differences in patellofemoral function, for a SP versus IP approach, with a greater than 10 point discrepancy in Kujala score at both 6 weeks and 12 months. In addition, there was a clinically important difference in VAS knee pain scores for patients at 12 months, but not at 6 weeks, postoperatively. These results contribute to the growing body of evidence demonstrating the functional and clinical benefits of the SP approach.
Level Of Evidence: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/BOT.0000000000002783 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
CSF1-R inhibition attenuates posttraumatic osteoarthritis and quadriceps atrophy following ligament injury.
J Physiol
December 2024
Center for Muscle Biology, University of Kentucky, Lexington, KY, USA.
Knee osteoarthritis contributes substantially to worldwide disability. Post-traumatic osteoarthritis (PTOA) develops secondary to joint injury, such as ligament rupture, and there is increasing evidence suggesting a key role for inflammation in the aetiology of PTOA and associated functional deficits. Colony stimulating factor 1 receptor (CSF1-R) has been implicated in the pathogenesis of musculoskeletal degeneration following anterior cruciate ligament (ACL) injury.
View Article and Find Full Text PDFPopliteal plexus block in total knee arthroplasty: a single-center randomized controlled double-blinded trial.
Reg Anesth Pain Med
December 2024
Faculty of Medicine, University of Geneva, Geneva, Switzerland
Introduction: Whether a popliteal plexus block improves postoperative pain following total knee arthroplasty remains debated. This randomized trial tested if adding a popliteal plexus block to a continuous femoral nerve block decreases postoperative opioid requirement.
Methods: We included 66 patients undergoing total knee arthroplasty.
Multimodal Rehabilitation Including Strengthening Exercise Is Effective in Improving Fear-Avoidance Beliefs in Individuals With Patellofemoral Pain: A Critically Appraised Topic.
J Sport Rehabil
December 2024
Department of Kinesiology, University of Connecticut, Storrs, CT, USA.
Clinical Scenario: Individuals with patellofemoral pain (PFP) present with a variety of neuromuscular and psychological deficits, with the "gold-standard" for treatment being rehabilitation programs with strengthening-based exercises. While such interventions primarily target pain and function measures, it is unknown whether psychological measures such as fear-avoidance beliefs (FABs) are also affected.
Clinical Question: Is rehabilitation including strengthening exercises effective in improving FABs in individuals with PFP?
Summary Of Key Findings: Three studies met the inclusion criteria and were included in the appraisal.
A biopsychosocial approach towards understanding disparities in exercise participation between Hispanic and non-Hispanic White patients living with knee osteoarthritis.
Soc Sci Med
December 2024
Miller School of Medicine, University of Miami, Miami, USA.
Engaging in regular exercise is essential for managing knee osteoarthritis (KOA) symptoms. Despite the established findings, sustained exercise adoption remains a challenge for KOA patients, with notable disparities among Hispanic patients, warranting a need to identify determinants that explain the racial discrepancy in exercise participation. The purpose of this study was to employ a biopsychosocial model to identify determinants of exercise participation and highlight racial disparities.
View Article and Find Full Text PDFAcute systemic macrophage depletion in osteoarthritic mice alleviates pain-related behaviors and does not affect joint damage.
Arthritis Res Ther
December 2024
Department of Internal Medicine, Division of Rheumatology, Rush University Medical Center, Chicago, IL, USA.
Background: Osteoarthritis (OA) is a painful degenerative joint disease and a leading source of years lived with disability globally due to inadequate treatment options. Neuroimmune interactions reportedly contribute to OA pain pathogenesis. Notably, in rodents, macrophages in the DRG are associated with onset of persistent OA pain.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!