[Tendinopathy of the patellar ligament secondary to transtendineal arthroscopy of the knee. Ultrasonographic evaluation]

Abstract

During knee arthroscopy, the transtendinous approach best visualizes articular structures, even though it may cause patellar tendinitis, following the surgical procedures. Thirty patients (22 men and 8 women) who had undergone transtendinous arthroscopy of the knee were submitted to clinical and US follow-up at 3, 6, 12 months. This monitoring was aimed at correlating clinical and instrumental findings of the above iatrogenic condition. Painful symptoms were present in 30% of the cases in group I, in 10% of group II and in no patient in group III. US demonstrated thickening of the patellar tendon in all the three groups of patients, with reduced echogenicity and blurred margins at the arthroscopic portal, plus decreasing gravity over time. The US pattern of arthroscopic surgical gap was observed in all patients in group I, in 10% of patients in group II and in none of the patients in group III. In conclusion because of its clinical course and of its US findings, in our experience patellar tendinopathy following transtendinous arthroscopy of the knee is not to be considered as a iatrogenic inflammatory or degenerative sequela, but as a physiological cicatricial evolution of the surgical transtendinous breach. The US follow-up of the latter allows the correct assessment of the recovering process.