129 Evaluating Long-Term (≫5 Years) Patient Reported Outcome Measures and Kneeling Function in Patients with Tibial Intramedullary Nails
H Johnson, A Han Win Aung, N Ahearn- Surgery
Abstract
Aim
1) To assess the long-term (>5 years) patient reported outcome measures (PROMs) and kneeling ability in patients with tibial intra-medullary nails (IMNs). 2) To correlate the PROMs with superior and anterior IMN cortex protrusion, measured radiologically.
Method
129 patients, from one UK centre, were invited to participate by completing a KOOS score, Kujala score, EQ-5D-5L and a four-posture kneeling assessment. Superior and anterior IMN prominence was measured using lateral radiographs. Pearson’s two-tailed correlation test was performed using SPSS v28.
Results
45 patients responded to the questionnaire. 81.8% of patients were satisfied with their surgery. 20.5% of patients experienced daily AKP. The mean Kujala score was 80.7 (74.5, 86.8). The mean KOOS score was 83.2 (77.9, 88.5), 83.9 (78.3, 89.5), 85.8 (79.6, 92.0), 70.7 (60.8, 80.7) and 72.8 (64.8, 80.8) for symptoms, pain, daily living, sport and quality of life, respectively. Participants found the praying position and high flexion kneel the most difficult postures, with pain being the most common limiting factor. More than half of participants found all four kneeling postures easy to achieve. No significant correlation was found between the overall KOOS or Kujala score and nail-plateau distance (p = 0.408, p = 0.979), nail-anterior cortex distance (p = 0.552, p = 0.492) or the overall nail prominence (p = 0.608, p = 729).
Conclusions
AKP effects a subset of patients more than five years post-tibial IMN, limiting their ability to kneel. Most patients experience little or no pain with good knee functionality. Tibial IMN prominence does not seem to be associated with AKP in our sample.