{
    "abstract": "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.\nProspective, parallel-group randomized control trial.\nTertiary level 1 trauma care center, Brisbane, Australia.\nSkeletally 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.\nAnterior 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.\nNinety-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).\nThis 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.\nTherapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.",
    "authors": [
        {
            "affiliation": "Department of Orthopaedic Surgery, Royal Brisbane and Women's Hospital, Brisbane, Australia.\nSchool of Medicine, The University of Queensland, Brisbane, Australia.",
            "firstname": "Gerrit J",
            "initials": "GJ",
            "lastname": "van de Pol"
        },
        {
            "affiliation": "Department of Orthopaedic Surgery, Royal Brisbane and Women's Hospital, Brisbane, Australia.",
            "firstname": "Daniel E",
            "initials": "DE",
            "lastname": "Axelrod"
        },
        {
            "affiliation": "Department of Orthopaedic Surgery, Queen Elizabeth II Jubilee Hospital, Brisbane, Australia ; and.",
            "firstname": "Christopher",
            "initials": "C",
            "lastname": "Conyard"
        },
        {
            "affiliation": "Department of Orthopaedic Surgery, Royal Brisbane and Women's Hospital, Brisbane, Australia.\nDepartment of Orthopaedic Surgery, Queen Elizabeth II Jubilee Hospital, Brisbane, Australia ; and.\nOrthopaedic Research Centre of Australia, Brisbane, Australia .",
            "firstname": "Kevin D",
            "initials": "KD",
            "lastname": "Tetsworth"
        }
    ],
    "conclusions": null,
    "copyrights": "Copyright \u00a9 2024 Wolters Kluwer Health, Inc. All rights reserved.",
    "doi": "10.1097/BOT.0000000000002783",
    "journal": "Journal of orthopaedic trauma",
    "keywords": [],
    "methods": null,
    "publication_date": "2024-02-12",
    "pubmed_id": "38345356",
    "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).",
    "title": "A Suprapatellar Approach, When Compared With an Infrapatellar Approach, Yields Less Anterior Knee Pain and Better Patellofemoral Joint Function, for Intramedullary Nailing of Diaphyseal Tibial Fractures: Results of a Randomized Controlled Trial.",
    "xml": "<Element 'PubmedArticle' at 0x7885070f6980>"
}