2015 ISAKOS Biennial Congress ePoster #1335
Ultrasonographic Evaluation of Harvested Patellar Tendon in Professional Football Players
Georgios N. Tzoanos, MD, Heraklion, Crete GREECE
Nikolaos Tsavalas, MD, Heraklion, Crete GREECE
Nikolaos Manidakis, MBChB, MRCS(Eng), Heraklion, Crete GREECE
Dimitrios Chardaloumpas, PhD, Nea Makri, Attiki GREECE
Alkiviadis Kalliakmanis, MD, PhD, Athens GREECE
Tzoanos Sports Clinic, Heraklion, Crete, GREECE
FDA Status Cleared
Summary: Patellar tendons after BTB ACL reconstruction in our group of football players were characterized by increased thickness and mostly low echogenicy at the site of the defect. Signs of solid healing were evident by 12 months in a minority of patients. No inflammatory changes were observed. Return to play didn’t seem to affect the normal reparative process of the patellar tendon.
To investigate the early structural changes of the patellar tendon following Bone-Patellar-Bone (BTB) autograft Anterior Cruciate Ligament (ACL) reconstruction.
Twenty six male and four female amateur football players, with a mean age of 25 years (range, 20-32 years) were enrolled in our study. They had undergone BTB autograft ACL reconstruction during the past year, and were examined at 10±2 SD months postoperatively.Each donor tendon was evaluated with a high frequency (12 MHz) linear-array ultrasound transducer (Philips ATL HDI 5000 Sono CT) and compared with the contralateral healthy one. All patients returned to fully participation at 7±1 SD (6-8) months after surgery, and exhibited no symptomatology at the time of the study. The maximum anteroposterior (MAP) and maximum transverse (MT) diameters of the patellar tendon and associated defect at the site of the tendon incision were measured at its proximal, middle and distal thirds using electronic calipers. The presence of vascular flow was examined with color and power Doppler imaging. Echogenicity of the patellar tendon defect was graded as low, mixed or normal compared to the contralateral tendon.
Results:The mean MAP diameter of the harvested tendon was significantly greater at all measured sites in comparison to the contralateral tendon (P<0.01). There was no statistically significant difference between the mean MT diameters of the donor and healthy tendons (P>0.05). The mean MAP diameter of the patellar tendon defect was 4.0±2.1 mm, 4.7±2.8 mm and 4.1±2.4 mm at the proximal, middle and distal third of the tendon respectively. Accordingly, the mean MT diameter of the defect was 3.3±2.2 mm (proximal third), 2.9±1.6 mm (middle third) and 2.1±0.9 mm (distal third). The vast majority (22) of tendon defects showed low echogenicity. Mixed echogenicity was found in 6 of them, while two patients demonstrated normal echogenicity of the harvested tendon, both at 12 months postoperatively. No tendon exhibited any signs of neovascularization.
Patellar tendons after BTB ACL reconstruction in our group of football players were characterized by increased thickness and mostly low echogenicy at the site of the defect. Signs of solid healing were evident by 12 months in a minority of patients. No inflammatory changes were observed in our asymptomatic subjects. Return to play didn’t seem to affect the normal reparative process of the patellar tendon.