Department of Radiology, Hôpital Erasme, Université Libre de Bruxelles, 808, Route de Lennik, 1070, Brussels, Belgium.
Skeletal Radiol. 2021 Mar;50(3):485-494. doi: 10.1007/s00256-020-03574-x. Epub 2020 Aug 16.
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.
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.
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.
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%.
前瞻性评估全膝关节置换术前和术后膝关节超声、剪切波弹性成像和 X 线检查中股四头肌和髌腱的早期变化。
对 23 例（16 例女性；年龄 51-85 岁，平均 66±9 岁）患者的膝关节进行术前、术后 6 周和 3 个月的 X 线、超声和剪切波弹性成像检查。通过 X 线评估髌股位置和髌腱长度；通过超声和剪切波弹性成像评估关节积液或滑膜炎、股四头肌和髌腱长度和厚度、回声、血管生成和僵硬度。
在术后早期，87%的患者有膝关节积液，43%的患者有滑膜炎迹象。51.5%（p<0.0001）的患者股四头肌肌腱显著增厚，93.8%（p<0.0001）的患者髌腱显著缩短，7.8%（p<0.0001）的患者髌腱显著缩短。87%的患者发现股四头肌肌腱内侧出现低回声缺陷。股四头肌肌腱的杨氏模量显著增加（p=0.0006），但髌腱无显著变化。
术后早期影像学检查发现的以下表现不应视为病理表现：关节积液、滑膜炎、股四头肌肌腱僵硬和厚度增加超过 50%、髌腱厚度增加超过 90%、股四头肌肌腱内侧局灶性缺陷、髌腱缩短超过 8%。
