Evaluation of Patellar Tendon Changes After Total Knee Arthroplasty Using Sonoelastography Publisher



Aghaghazvini L ; Sherafatvaziri A ; Mirzamohamadi A ; Taheri A ; Vosoughi F ; Dariush R ; Shayan Moghadam R
Source: Journal of Diagnostic Medical Sonography Published:2026

Abstract

Objective: The aim of this study was to investigate structural and functional changes in the patellar tendon following total knee arthroplasty (TKA), using sonographic and sonoelastography techniques. Materials and Methods: Thirty-five patients undergoing primary TKA were prospectively assessed preoperatively and 6 months postoperatively. An experienced musculoskeletal radiologist evaluated grayscale indices (eg, tendon length, proximal/middle/distal thickness) and sonoelastography indices (eg, color mapping and shear wave velocity [SWV]), in knee extension and 90° flexion. Results: Significant increases in tendon length, thickness, and SWV were observed in flexion postsurgery. The prevalence of the homogeneous blue sonoelastography pattern decreased substantially in flexion. In extension, tendon length and thickness also increased significantly; however, SWV changes were inconsistent. The homogeneous blue sonoelastography pattern remained the predominant qualitative finding in extension, both preoperatively and postoperatively, indicating no significant qualitative alteration in this position. Conclusion: Sonoelastography provided valuable quantitative and qualitative measurements for assessing the patellar tendon postoperatively, in this cohort. Further studies are needed to fully interpret post-TKA tendon elasticity changes. © The Author(s) 2026