Document Detail


The fate of patellar tendon and infrapatellar fat pad after arthroscopy via central portal.
MedLine Citation:
PMID:  18779950     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Central patellar (CP) portal is an accessory portal in arthroscopic knee surgery, which generally is considered to be safe. In this cross sectional study, we aimed to delineate the clinical and radiological outcome of patellar tendon (PT) and Hoffa's fat pad after the use of this approach. From our hospital records, patients who underwent arthroscopy via CP portal were identified and were invited for the study. There were16 men and 4 women with a mean age of 32 years. Mean follow-up time was 28 months. Meniscectomy had been performed for irreparable bucket-handle type medial meniscal tears in all patients. At the latest follow-up, no patients had anterior knee pain and physical examination was normal. Mean PT thickness of operated knees measured with Ultrasonography was 5.63+/-1.56, while it was 3.76+/-0.46 mm in contralateral knees and the difference was significant. Contour irregularity of PT and focal hypoechoic areas were found in 17 patients, two of which also had hyperechogenic calcification focuses. Abnormal signal intensity of PT was also found in 17 patients with Magnetic Resonance Imaging (MRI). Eleven of these had decreased signal intensity within the tendon which was interpreted as fibrosis. In six patients, increased signal intensity, radiologically similar to chronic tendinitis, was detected. Four patients had decreased signal intensity in the Hoffa's fat pad. Local fibrous tissues in patellar tendon might cause weakness in the tendon. This study showed that although CP portal did not cause any clinical problems in a low demand group of patients, it leads to a significant radiological sequela in the tendon, biomechanical significance of which needs to be clarified.
Authors:
Ahmet Bayar; Egemen Turhan; Tülay Ozer; Selçuk Keser; Ahmet Ege; Zuhal Erdem
Publication Detail:
Type:  Journal Article     Date:  2008-09-09
Journal Detail:
Title:  Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA     Volume:  16     ISSN:  0942-2056     ISO Abbreviation:  Knee Surg Sports Traumatol Arthrosc     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-11-25     Completed Date:  2009-04-29     Revised Date:  2009-05-04    
Medline Journal Info:
Nlm Unique ID:  9314730     Medline TA:  Knee Surg Sports Traumatol Arthrosc     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1114-20     Citation Subset:  IM    
Affiliation:
Department of Orthopaedics and Traumatology, Faculty of Medicine, Zonguldak Karaelmas University, 67600, Kozlu, Zonguldak, Turkey. bayarahmet@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Arthroscopy / adverse effects*
Cross-Sectional Studies
Female
Fibrosis / etiology,  pathology
Follow-Up Studies
Humans
Male
Menisci, Tibial / injuries*,  surgery*
Patella / pathology*,  surgery
Tendinopathy / etiology,  pathology
Young Adult
Comments/Corrections
Comment In:
Knee Surg Sports Traumatol Arthrosc. 2009 May;17(5):555-6; author reply 557   [PMID:  19357835 ]

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