Anterior knee pain with intramedullary nail or LON? (tibias)

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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?

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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.