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Sonographic and radiographic evaluation of the extensor tendons in early postoperative period after total knee arthroplasty

par Créteur, Viviane;De Angelis, Riccardo ;Absil, Julie ;Kyriakidis, Theofylaktos ;Madani, Afarine
Référence Skeletal radiology
Publication Publié, 2020-10-01

Article révisé par les pairs

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Résumé :

Objective: To prospectively assess the early changes in the quadriceps and patellar tendons before and after total knee arthroplasty using ultrasound, shear wave elastography, and X-rays. Materials and methods: Radiographs, ultrasound, and shear wave elastography were performed on 23 patients (16 women; aged 51–85, mean 66 ± 9 years) before and after surgery at 6 weeks and on 11 patients at 3 months. Patellar position and patellar tendon lengths were evaluated by radiography; joint effusion or synovitis, quadriceps and patellar tendon lengths, and thicknesses, echogenicity, vascularity, and stiffness were assessed with ultrasound and shear wave elastography. Results: In the early postoperative period, 87% of the patients had joint effusion, and 43% had signs of synovitis. There was a significant thickening of the quadriceps tendon in 51.5% (p <.0001) and of the patellar tendon in 93.8% (p <.0001) of patients with a significant shortening of the patellar tendon in 7.8% (p <.0001). A hypoechoic defect on the medial aspect of the quadriceps tendon was found in 87% of the patients. There was a significant increase in Young’s modulus in the quadriceps tendon (p =.0006) but not in the patellar tendon. Conclusion: The following should not be considered to be pathological findings at early postoperative imaging: joint effusion, synovitis, increasing of stiffness and thickening of quadriceps tendons by more than 50%, thickening of patellar tendon by more than 90%, focal defect through the medial aspect of the quadriceps tendon, and shortening of the patellar tendon by 8%.