PMID- 38299066
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240202
IS  - 0972-978X (Print)
IS  - 0972-978X (Electronic)
IS  - 0972-978X (Linking)
VI  - 51
DP  - 2024 May
TI  - Chronic knee pain following infrapatellar/suprapatellar magnetic intramedullary 
      lengthening nails versus external fixators in limb length discrepancy: A 
      retrospective review.
PG  - 7-11
LID - 10.1016/j.jor.2023.11.071 [doi]
AB  - AIMS & OBJECTIVES: Prior to the popularization of magnetic intramedullary nails 
      (MILNs), gradual deformity correction using external fixation was the norm in 
      limb lengthening. Trauma literature has shown MILN via a suprapatellar approach 
      (SP) to be associated with less knee pain than either an infrapatellar entry (IP) 
      or external fixation. Yet, no research has investigated chronic knee pain and 
      MILNs. We assessed differences in chronic knee pain following lengthening via an 
      IP or SP approach with an MILN versus external fixation. MATERIALS & METHODS: We 
      reviewed 147 limbs (55 MILN/IP, 22 MILN/SP, 71 external fixator) in 124 patients 
      who underwent tibial lengthening with >/=12 months follow-up between February 2012 
      and July 2020. Knee pain was assessed pre- and postoperatively at 6 and 12 
      months, with the Lysholm Knee Scoring Scale (LKSS) and numeric pain scale (0-10). 
      Differences in knee pain outcomes were compared across methods, with subgroup 
      analysis of MILN/SP and MILN/IP. RESULTS: Mean LKSS was 96.3 for external 
      fixation and 88.5 for MILN (P = .011). In the MILN subgroups, mean LKSS was 91.7 
      for IP and 85.3 for SP. The IP group reported a lesser mean pain score (0.6 
      versus 2.1) at 12 months. Bilateral nail recipients demonstrated no knee pain 
      differences versus unilateral. At 12 months postoperative, external fixation had 
      better knee outcomes. CONCLUSION: Tibial lengthening with external fixation was 
      associated with less chronic anterior knee pain and better functional outcomes 
      than MILN overall. In terms of MILN approach, IP surpassed SP on subjective pain 
      scores. Larger tibial lengthening and knee pain studies are warranted.
CI  - (c) 2023 Professor P K Surendran Memorial Education Foundation. Published by 
      Elsevier B.V. All rights reserved.
FAU - Hlukha, Larysa P
AU  - Hlukha LP
AD  - International Center for Limb Lengthening, Rubin Institute for Advanced 
      Orthopedics, Sinai Hospital of Baltimore, 2401 W. Belvedere Ave., Baltimore, MD, 
      21215, USA.
FAU - Sax, Oliver C
AU  - Sax OC
AD  - International Center for Limb Lengthening, Rubin Institute for Advanced 
      Orthopedics, Sinai Hospital of Baltimore, 2401 W. Belvedere Ave., Baltimore, MD, 
      21215, USA.
FAU - Kowalewski, Kyle A
AU  - Kowalewski KA
AD  - International Center for Limb Lengthening, Rubin Institute for Advanced 
      Orthopedics, Sinai Hospital of Baltimore, 2401 W. Belvedere Ave., Baltimore, MD, 
      21215, USA.
FAU - Bains, Sandeep S
AU  - Bains SS
AD  - International Center for Limb Lengthening, Rubin Institute for Advanced 
      Orthopedics, Sinai Hospital of Baltimore, 2401 W. Belvedere Ave., Baltimore, MD, 
      21215, USA.
FAU - Dubin, Jeremy
AU  - Dubin J
AD  - International Center for Limb Lengthening, Rubin Institute for Advanced 
      Orthopedics, Sinai Hospital of Baltimore, 2401 W. Belvedere Ave., Baltimore, MD, 
      21215, USA.
FAU - Herzenberg, John E
AU  - Herzenberg JE
AD  - International Center for Limb Lengthening, Rubin Institute for Advanced 
      Orthopedics, Sinai Hospital of Baltimore, 2401 W. Belvedere Ave., Baltimore, MD, 
      21215, USA.
FAU - Assayag, Michael J
AU  - Assayag MJ
AD  - International Center for Limb Lengthening, Rubin Institute for Advanced 
      Orthopedics, Sinai Hospital of Baltimore, 2401 W. Belvedere Ave., Baltimore, MD, 
      21215, USA.
FAU - McClure, Philip K
AU  - McClure PK
AD  - International Center for Limb Lengthening, Rubin Institute for Advanced 
      Orthopedics, Sinai Hospital of Baltimore, 2401 W. Belvedere Ave., Baltimore, MD, 
      21215, USA.
LA  - eng
PT  - Journal Article
DEP - 20231206
PL  - India
TA  - J Orthop
JT  - Journal of orthopaedics
JID - 101233220
PMC - PMC10825912
OTO - NOTNLM
OT  - External fixation
OT  - Infrapatellar
OT  - Magnetic intramedullary nails
OT  - Suprapatellar
OT  - Tibial lengthening
EDAT- 2024/02/01 06:42
MHDA- 2024/02/01 06:43
PMCR- 2025/05/01
CRDT- 2024/02/01 04:25
PHST- 2023/11/21 00:00 [received]
PHST- 2023/11/26 00:00 [accepted]
PHST- 2025/05/01 00:00 [pmc-release]
PHST- 2024/02/01 06:43 [medline]
PHST- 2024/02/01 06:42 [pubmed]
PHST- 2024/02/01 04:25 [entrez]
AID - S0972-978X(23)00347-1 [pii]
AID - 10.1016/j.jor.2023.11.071 [doi]
PST - epublish
SO  - J Orthop. 2023 Dec 6;51:7-11. doi: 10.1016/j.jor.2023.11.071. eCollection 2024 
      May.