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Ultrasonographic and Power Doppler Evaluation of the Patellar Tendon Ten Years After Harvesting Its Central Third for Reconstruction of the Anterior Cruciate Ligament

Comparison of Patients Without or With Anterior Knee Pain

Timo Järvelä, MD, PhD^*,,, Timo Paakkala, MD, PhD, Pekka Kannus, MD, PhD^,||, Jarmo Toivanen, MD, PhD and Markku Järvinen, MD, PhD^,

From the Division of Orthopaedics and Traumatology, Department of Surgery, Tampere University Hospital, Tampere, Finland, Medical School, University of Tampere, Tampere, Finland, Department of Radiology, Tampere University Hospital, Tampere, Finland, and ^|| Accident and Trauma Research Center and Tampere Research Center of Sports Medicine, the UKK Institute, Tampere, Finland.

^* Address correspondence and reprint requests to Timo Järvelä, MD, PhD, Division of Orthopaedics and Traumatology, Department of Surgery, Tampere University Hospital, P.O. Box 2000, FIN 33521 Tampere, Finland.

Background: The long-term morphologic changes in the patellar tendon after harvesting its central third for the reconstruction of the anterior cruciate ligament have not been reported.

Hypothesis: Sonographic morphologic changes in the harvested patellar tendon are common 10 years after the harvesting procedure.

Study Design: Retrospective cohort study.

Methods: Thirty-one patients who had undergone an anterior cruciate ligament reconstruction using central-third bone-patellar tendon-bone autograft with a closure of the patellar tendon defect were included in this study. An ultrasonographic and Power Doppler examination was performed at a mean follow-up of 10 years.

Results: Ultrasonography of the harvested patellar tendon showed intratendinous calcification in 9 patients, hypoechoic lesion in 20 patients, hyperechoic lesion in 1 patient, and peritendinous changes in 1 patient. Only 3 (9.7%) of the 31 patients had no changes in the harvested patellar tendon. No abnormality was visible in the contralateral (normal) patellar tendons of the 31 patients. The harvested patellar tendon was significantly thicker than the contralateral patellar tendon (P < 0.05).

Conclusions: Sonographic morphologic changes of the patellar tendon were common 10 years after the harvesting procedure, although no evidence of inflammatory process, as could be seen in Power Doppler flow, was found inside of any patellar tendon.

Key Words: patellar tendon • ultrasonography • Power Doppler • anterior cruciate ligament reconstruction • anterior knee pain

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