TY - JOUR
T1 - Difference in Pain, Complication Rates, and Clinical Outcomes After Suprapatellar Versus Infrapatellar Nailing for Tibia Fractures? A Systematic Review of 1447 Patients
AU - Bleeker, Nils Jan
AU - Reininga, Inge H. F.
AU - van de Wall, Bryan J. M.
AU - Hendrickx, Laurent A. M.
AU - Beeres, Frank J. P.
AU - Duis, Kaj Ten
AU - Doornberg, Job N.
AU - Jaarsma, Ruurd L.
AU - Kerkhoffs, Gino M. M. J.
AU - IJpma, Frank F. A.
N1 - Publisher Copyright: © 2021 The Author(s).
PY - 2021/8/1
Y1 - 2021/8/1
N2 - Objectives: To assess the effectiveness of suprapatellar (SP)-nailing versus infrapatellar (IP)-nailing of tibia fractures in anterior knee pain, complications (retropatellar chondropathy, infection, and malalignment) and physical functioning and quality of life. A clinical question-driven and thorough systematic review of current literature is provided. Data source: PubMed and Embase databases were searched for studies published between 2010 and 2020 relating to SP and IPnailing of tibia fractures. The study is performed in concordance with PRISMA-guidelines. Study selection: Studies eligible for inclusion were randomized controlled trials, prospective and retrospective observational studies reporting on outcomes of interest. Data extraction: Data extraction was performed independently by 2 assessors. Methodological quality and risk of bias was assessed according to the guidelines of the McMaster Critical Appraisal. Data synthesis: Continuous variables are presented as means with SD and dichotomous variables as frequency and percentages. The weighted mean, standardized weighted mean differences, and 95% confidence interval were calculated. A pooled analysis could not be performed because of differences in outcome measures, time-points, and heterogeneity. Results: Fourteen studies with 1447 patients were analyzed. The weighted incidence of anterior knee pain was 29% after SP-nailing and 39% after IP-nailing, without reported significance. There was a significant lower rate of malalignment after the SP-approach (4% vs. 26%) with small absolute differences in all planes. No substantial differences were observed in retropatellar chondropathy, infection, physical functioning, and quality of life. Conclusions: This systematic review does not reveal superiority of either technique in any of the respective outcomes of interest. Definitive choice should depend on the surgeon's experience and available resources.
AB - Objectives: To assess the effectiveness of suprapatellar (SP)-nailing versus infrapatellar (IP)-nailing of tibia fractures in anterior knee pain, complications (retropatellar chondropathy, infection, and malalignment) and physical functioning and quality of life. A clinical question-driven and thorough systematic review of current literature is provided. Data source: PubMed and Embase databases were searched for studies published between 2010 and 2020 relating to SP and IPnailing of tibia fractures. The study is performed in concordance with PRISMA-guidelines. Study selection: Studies eligible for inclusion were randomized controlled trials, prospective and retrospective observational studies reporting on outcomes of interest. Data extraction: Data extraction was performed independently by 2 assessors. Methodological quality and risk of bias was assessed according to the guidelines of the McMaster Critical Appraisal. Data synthesis: Continuous variables are presented as means with SD and dichotomous variables as frequency and percentages. The weighted mean, standardized weighted mean differences, and 95% confidence interval were calculated. A pooled analysis could not be performed because of differences in outcome measures, time-points, and heterogeneity. Results: Fourteen studies with 1447 patients were analyzed. The weighted incidence of anterior knee pain was 29% after SP-nailing and 39% after IP-nailing, without reported significance. There was a significant lower rate of malalignment after the SP-approach (4% vs. 26%) with small absolute differences in all planes. No substantial differences were observed in retropatellar chondropathy, infection, physical functioning, and quality of life. Conclusions: This systematic review does not reveal superiority of either technique in any of the respective outcomes of interest. Definitive choice should depend on the surgeon's experience and available resources.
KW - Anterior knee pain
KW - Complications
KW - General quality of life
KW - Infrapatellar
KW - Intramedullary nailing
KW - Physical functioning
KW - Suprapatellar
KW - Tibia fractures
UR - http://www.scopus.com/inward/record.url?scp=85111776644&partnerID=8YFLogxK
U2 - https://doi.org/10.1097/BOT.0000000000002043
DO - https://doi.org/10.1097/BOT.0000000000002043
M3 - Review article
C2 - 34267147
SN - 0890-5339
VL - 35
SP - 391
EP - 400
JO - Journal of Orthopaedic Trauma
JF - Journal of Orthopaedic Trauma
IS - 8
ER -