Sonoelastographic evaluation of the distal femoral cartilage in patients with anterior cruciate ligament reconstruction

Abstract

ÖZAmaç: Bu çalışmada ön çapraz bağ (ÖÇB) tamiri yapılan hastalarda distal femoral kıkırdağın sonoelastografik özellikleri değerlendirildi. Hastalar ve yöntemler: Tek taraflı ÖÇB tamiri yapılan 28 hastanın (27 erkek, 1 kadın, ort. yaş 31.7±7.1 yıl; dağılım 22-48 yıl) demografik özellikleri ve ameliyat verileri değerlendirildi. Yirmi iki hastada (%78.6) patellar tendon grefti ve altı hastada (%21.4) hamstring tendon grefti ile tamir uygulandı. Fonksiyonel değerlendirme için Lysholm diz skoru ve alt ekstremite gücü için sandalyeye oturma kalkma testi kullanıldı. Ameliyat edilen dizler ve sağlıklı dizlerde medial, interkondiler ve lateral distal femoral kıkırdak kalınlıkları B-mod ultrasonografi, gerilim oranları ise gerçek zamanlı sonoelastografi ile ölçüldü. Bulgular: Ameliyat sonrası ortalama takip süresi 20.4±9.8 ay idi. Ortalama Lysholm diz ve hasta memnuniyeti skorları sırasıyla 88.0±8.5 ve 8.2±1.8 idi. Kıkırdak kalınlıkları ameliyatlı ve sağlıklı dizler arasında benzerdi (tamamı p>0.05). Ameliyatlı dizlerde medial distal femoral kıkırdağın sonoelastografik gerilim oranı anlamlı olarak yüksek idi (daha yumuşak kıkırdak) (p= 0.026). Ameliyatlı dizlerde medial kıkırdak gerilim oranı farklılığı ile alt ekstremite kas gücü arasında negatif korelasyon vardı (p= 0.009, r= -0.487). Sonuç: B-mod ultrasonografi ile değerlendirildiğinde ameliyatlı ve sağlıklı dizler arasında kıkırdak kalınlığı açısından farklılık olmasa da ameliyatlı taraflarda medial distal femoral kıkırdakta sonoelastografik gerilim oranı değişikliklerinin saptanması ÖÇB tamirini takiben erken yapısal değişikliklere işaret ediyor olabilir. Kıkırdak yapısındaki değişiklikler ile sonoelastografi özellikleri arasındaki bu ilişkinin klinik etkilerinin açığa çıkarılması için ileri çalışmalara ihtiyaç vardır.Anahtar sözcükler: Ön çapraz bağ; distal femoral kıkırdak; elastografi; gerilim oranı; ultrason. ABSTRACT Objectives:This study aims to evaluate sonoelastographic properties of the distal femoral cartilage in patients with anterior cruciate ligament (ACL) reconstruction. Patients and methods: Demographic characteristics and operative data of 28 patients (27 males, 1 female; mean age 31.7±7.1 years; range 22 to 48 years) with unilateral ACL reconstruction were evaluated. Reconstruction was performed with patellar tendon graft in 22 patients (78.6%) and hamstring tendon graft in six patients (21.4%). Lysholm knee score was used for functional evaluation and chair stand test was used for lower extremity strength. Medial, intercondylar, and lateral distal femoral cartilage thicknesses of operated knees and healthy knees were measured with B-mode ultrasound, while strain ratios were measured with real time sonoelastography. Results: Postoperative mean follow-up duration was 20.4±9.8 months. Mean Lysholm knee and patient satisfaction scores were 88.0±8.5 and 8.2±1.8, respectively. Cartilage thicknesses were similar between operated and healthy knees (all p>0.05). Sonoelastographic strain ratio of medial distal femoral cartilage in operated knees was significa...

Sonoelastography of the knee joint

“…There have been a few cartilage imaging studies using real‐time elastosonography (RTE), which has increased in importance and range of use during recent years (De Maeseneer et al, ; Saarakkala et al, ; Akkaya et al, ). Real‐time elastosonography, which is used to measure the elasticity of tissues, successfully differentiates hard from soft tissues (Castriota‐Scanderbeg et al, ; Lee et al, ), and it has been reported that cartilage, a very hard structure, loses its hardness in pathological areas (Disler et al, ; Kaleva et al, ; Saarakkala et al, ; Cay et al, ).…”

Ultrasonographic Assessment of Femoral Cartilage in Individuals With Anterior Cruciate Ligament Reconstruction: A Case-Control Study

“…18 Using US, clinicians can specifically assess the size of the anterior femoral cartilage, which is traditionally determined by measuring thickness at 3 discrete locations on the anterior femur. 11,19,20 Akkaya et al 21 are the only researchers to report using US to assess femoral cartilage thickness after ACLR, and they observed no differences in cartilage thickness between the ACLR and contralateral limbs. However, no researchers to date have used US to compare femoral cartilage size between individuals with unilateral ACLR and uninjured control participants.…”

Association between patellofemoral congruence and patellofemoral chondropathy in patients with anterior knee pain: A T2 mapping knee MRI study

“…Physiological thinning of the PFJ cartilage develops with older age, even in the absence of cartilage disease. [2][3][4] Atik et al, [3] showed that, due to reduced interstitial fluid content, the cartilage becomes harder with older age and less adaptive with various changes. Here, we recruited the control group from patients with a similar average age as the control group, so that the relationship between cartilage structure and morphology could be more reliably compared.…”

“…[2,3] Cartilage has been shown to increase water content in the presence of collagen, and collagen content is reduced by age or degeneration of the cartilage. [4] This relationship forms the basis of the T 2 mapping technique, in which T 2 relaxation time increases. Increased T 2 relaxation time can be detected using colored graphics that provide information about tissue degeneration.…”