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Arthrofibrosis Associated with Total Knee Arthroplasty: Gray-Scale and Power Doppler Sonographic Findings

Jens G. Boldt1,2, Urs K. Munzinger1, Marco Zanetti3 and Juerg Hodler3

1 Department of Orthopedic Surgery, Schulthess Clinic, Lenggstrasse 2, Zurich CH-8008, Switzerland.
2 Present address: Department of Orthopedic Surgery, St. Vinzenz Hospital, Schloss Strasse 85, Düsseldorf D-40477, Germany.
3 Department of Radiology, Orthopedic University Hospital Balgrist, Forchstrasse 340, Zürich CH-8008, Switzerland.



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  		Fig. 1. —49-year-old man 28 months after total right knee arthroplasty. Photograph shows typical clinical appearance of arthrofibrosis, with diffuse swelling of knee. On examination, swelling is firm, not painful, and not fluctuating.

 


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  		Fig. 2. —58-year-old woman 26 months after total right knee arthroplasty. Sonography shows increased synovial hypertrophy associated with arthrofibrosis. Transverse power Doppler sonogram through medial parapatellar recess of right knee shows prominent (grade 3) neovascularity (curved arrow) in ventral and medial parts of thickened synovial membrane (between straight arrows). F = femoral condyle.

 


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  		Fig. 3. —69-year-old man in control group who has well-functioning knee replacement 25 months after total right knee arthroplasty. Transverse sonogram through medial parapatellar recess of right knee shows normal thickness of synovial membrane (arrow points to anterior synovial membrane, calipers measure anterior [x – x] and posterior [+ – +] synovial membranes). F = femoral condyle.

 

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