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[Jason2020]

Hi again,

So I'm reading that intramedullary nail usage for tibial lengthening has a high risk of permanent anterior knee pain. How high is this risk?

Is this only associated with the intramedullary nails like Precice, Stryde, Guichet and Betzbone? Or is it with LON?

I was looking to do Betz on the femurs and then LON on the tibias.

Is there anyone here who has done tibial lengthening via intramedullary nail? What can you tell me about the permanent pain?

[Medium Drink Of Water]

I don't know the risk.  Nobody else does either since there isn't a big database of patients.  There are some small studies where nobody reported it, but I wasn't in those studies.  It's definitely not zero.

What I believe I have is tendonitis in my patellar ligaments, which surgeons cut a slit in so they can slide the nails into the tibias.  So the device wouldn't matter.  Maybe my surgeon did a bad job on me, maybe I had a bad reaction to a properly-performed procedure.

When I was lengthening my knees were very stiff, and they felt like they were going to burst if I bent them too far, for example trying to squat.  It was a weird thing to feel; you wouldn't normally expect your knees to feel that way.  I got big cortisone injections into each knee a couple of times which made the problem mostly go away temporarily, but the doctor said it's not good to use too much of that stuff, so mostly I didn't bend my knees during the five months I was there.

Now they're a little stiff, and when I kneel on a hard surface they feel tender and give me mild pain.

[Jamesy998]

Hi again,

So I'm reading that intramedullary nail usage for tibial lengthening has a high risk of permanent anterior knee pain. How high is this risk?

Is this only associated with the intramedullary nails like Precice, Stryde, Guichet and Betzbone? Or is it with LON?

I was looking to do Betz on the femurs and then LON on the tibias.

Is there anyone here who has done tibial lengthening via intramedullary nail? What can you tell me about the permanent pain?

I know two former patients with those nails with absolutely no pain. Couple years post op and having asked my doctor before getting the surgery done there have been no reports after the full consolidation. There is bound to be people who will suffer from that pain but no one can tell you the exact stats.

[Arcon]

Hi again,

So I'm reading that intramedullary nail usage for tibial lengthening has a high risk of permanent anterior knee pain. How high is this risk?

Is this only associated with the intramedullary nails like Precice, Stryde, Guichet and Betzbone? Or is it with LON?

I was looking to do Betz on the femurs and then LON on the tibias.

Is there anyone here who has done tibial lengthening via intramedullary nail? What can you tell me about the permanent pain?

From what I understand anterior knee pain can happen after tibia nailing in general, not just LL. It is common but not permanent.

[Jason2020]

So my concerns were raised by comments Dr Pili made on his website saying that there was a high risk of anterior knee pain when using the intradmedullary nail and I read this elsewhere in an academic paper. I am however going to raise these points with several surgeons including if possible Dr Pili to be absolutely certain.