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[a]

We all know that there is a %15 risk of having a permanent knee-pain due to internal methods.
I just wanted to ask that, after which part of the procedure we can be sure that we will not have a permanent knee pain? Is it after consolidation or way earlier than that?

[ghkid2019]

The knee pain can develop in the long term , talking 5 to 10 years. You may go through a few years of pain free and then it manifests itself out of no where.

[a]

What are the reasons that might increase the probability of its occurrence?
I mean, why would it start after 5 years or anything, is there an actual explanation for that?

[a]

Also, do LON and internal methods have the same possibility rate or is LON better? (as avoiding the knee pain)

[ghkid2019]

Reaming of the tibias through the patella with a nail is the culprit. The physiological explanation is not known or thoroughly researched as of yet.

LON would cause the exact same issue. It is still a nail.

The only method to avoid this is pure externals (illizarov). Then again, it's the longest time in hardware, like 9 months in frames for 5cm. I personally would never do it. But it's the safest for long term quality of life.

[Hagane]

i had a chat with cyborg4life  because he did internal tibias
he had his procedure done i belive 8 years ago and reports he is free of knee pain
he attributed it to being religious with his physio

to the best of my judgment: wait until after the removal of the rods. (obvs due to the retrauma to the patellar tendon)
based on what ive seen with cosmetic plastic surgery. the body takes a long time for the swelling to go down. for example if you get an implant in your face or get your nose done. you will have swelling for months before it "sets in". so having pain 1 -2 years post op i wouldn't consider to be the realm of chronic just yet. i would love to hear some updates from members like myevolution to update on the condition of their knees

i tried looking up studies about anterior knee pain and tibial nailing, however most studies were done on trauma patients so i dont know if that will have and effect on the results

anyways
while no one can guarentee that you wont get it, i belive you can lower your risks by being diligent with your pt long after youre finished consolidation. once youve had your nails removed, perhaps getting PRP treatment or running hgh for a couple months will help reduce the amount of scar formation.

[Hagane]

i havnt had a chat with any of the LL surgeons yet, but a parapatellar approach has been shown to have less pain compared to trans patellar or supra patellar

[a]

Thank you so much for the replies.