Objective

The purpose of this technical report is to review the sonographic spectrum of abnormalities accounting for peri-articular pain after knee replacement surgery, as well as to demonstrate the clinical utility of ultrasound in the diagnosis and treatment of this subset of patients.

Materials and methods

Utilizing an imaging report database, we performed a search for ultrasound examinations performed by a single radiologist for knee pain after knee arthroplasty at our institution over a 10-year period. The search yielded 63 patients, whom we have categorized by causative pathology, with representative diagnostic and procedural ultrasound images selected for inclusion.

Results

Our search yielded multiple causes of peri-articular knee pain after arthroplasty, including medial and lateral retinacular impingement and scarring, iliotibial band or conjoined tendon irritation, popliteus tendon impingement, medial collateral ligament impingement, pes anserine bursitis, and scarring of Hoffa’s fat pad.

Conclusion

While knee arthroplasty is an often-successful procedure, it can be complicated by post-operative peri-articular knee pain. Ultrasound provides a valuable tool for the diagnosis of painful peri-articular knee pathology, as it allows for both static and dynamic evaluation, as well as direct correlation with patient symptoms, and is not confounded by the metal components. In addition to its diagnostic utility, ultrasound can also guide diagnostic and/or therapeutic injections of anesthetic and corticosteroid. Given these advantages, ultrasound is an important tool in managing the painful post-arthroplasty knee.

中文翻译：

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膝关节置换术后关节周围疼痛的诊断超声和超声引导注射

客观的

本技术报告的目的是回顾膝关节置换术后关节周围疼痛的超声异常谱，并证明超声在诊断和治疗这部分患者中的临床应用。

材料和方法

利用影像报告数据库，我们搜索了 10 年来我们机构膝关节置换术后膝关节疼痛的一位放射科医师进行的超声检查。搜索产生了 63 名患者，我们根据病因病理对其进行了分类，并选择了具有代表性的诊断和程序超声图像进行纳入。

结果

我们的研究发现了关节置换术后膝关节周围疼痛的多种原因，包括内侧和外侧支持带撞击和瘢痕形成、髂胫束或联合肌腱刺激、腘肌腱撞击、内侧副韧带撞击、鹅足滑囊炎和 Hoffa 脂肪垫瘢痕形成。

结论

虽然膝关节置换术是一种经常成功的手术，但术后膝关节周围疼痛可能会使其复杂化。超声为疼痛性膝关节周围病变的诊断提供了一种有价值的工具，因为它可以进行静态和动态评估，并与患者症状直接相关，并且不会被金属成分混淆。除了其诊断效用之外，超声还可以指导麻醉剂和皮质类固醇的诊断和/或治疗注射。鉴于这些优势，超声是治疗膝关节置换术后疼痛的重要工具。