Background/Purpose: In spite of the fact that periarticular post-traumatic soft tissue injuries of the knee were considered less important than the knee joint pathology itself, they are disorders with a high risk of disability, with potential to affect functioning and quality of life causing thus important socioeconomic implications. The main objectives of our study are to point out the necessity of an ultrasonography score that can be correlated with a functional score (in order to quantify the evolution of nonsurgical periarticular post-traumatic soft tissue injuries of the knee) and to prove the importance of a long-term rehabilitation treatment of this pathology.

Methods:

We included into 1-year randomized, prospective study a number of 159 patients diagnosed with different types of nonsurgical periarticular post-traumatic soft tissue injuries of the knee: soft tissues edema, quadriceps tendon lesions (tendinitis or partial tear), prepatellar or infrapatellar bursitis, bursitis of the pes anserinus, lesions of the patellar retinaculum (elongation or partial tear), lesions of the medial collateral ligament (elongation, partial or total tear) and lesions of the iliotibial band (friction syndrome with or without bursitis). Group A suffered traumatic events on healthy knee joint. Group B patients had pre-existing knee lesions. Group A₁ (41 patients) and B₁ (38 patients) followed a medical treatment, while group A₂ (39 patients) and B₂ (41 patients) followed both medical and rehabilitation therapy. All patients were assessed initially, after 6 months and after 1 year using functional evaluation (KOOS: Knee injury and Osteoarthritis Outcome Score) and knee ultrasonography (quantified in a self-developed ultrasonography score).

Results:

At the beginning of the study we found no statistically significant difference of total US scores and of total KOOS scores between group A₁ (US=6.95±1.378; KOOS=143.71±7.497) and A₂ (US=6.92±1.403; KOOS=144.33±8.358), and between group B₁ (US=8.58±1.328; KOOS=187.26±12.326) and B₂ (US=8.51±1.287; KOOS=187.17±10.89). At the final assessment group A₂ and B₂ had significant decrease both of total US scores (p<0.01) and total KOOS scores (p<0.001) (US=3.10±1.142 and KOOS=57.44±5.702, respectively US=4.54±1.14 and KOOS=95.8±9.988) in comparison to group A₁ (US=3.76±0.994; KOOS=95.15±8.519), respectively B₁ (US=5.32±1.068; KOOS=130.89±10.506). When compared to group B₂, group A₂ had statistically very significant decreased total US scores (U=311; z=-4.83; p<0.001) and total KOOS scores (U=3; z=-7.70; p<0.001). No statistic correlation between the two assessment scores (ultrasonography score and KOOS score) was revealed.

Conclusion: The best functional results were recorded in patients with post-traumatic soft tissue injuries on a healthy knee joint and that followed both a medical treatment and a long-term rehabilitation. We propose a self-ultrasonography protocol that can monitor the progression in time of this pathology. Both functional and ultrasonography assessment scores are necessary in evaluation of periarticular soft tissue injuries of the knee.

ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-assessment-and-treatment-of-nonsurgical-periarticular-post-traumatic-soft-tissue-injuries-of-the-knee/