Isolated popliteus tendon injury does not lead to abnormal laxity in posterior-stabilised total knee arthroplasty

Ghosh, Kanishka M.; Hunt, Nicola; Blain, Alasdair; Athwal, Kiron K.; Longstaff, Lee M.; Amis, Andrew A.; Rushton, Steven; Deehan, David J.

doi:10.1007/s00167-014-3488-1

Cited by 21 publications

(29 citation statements)

References 32 publications

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“…Our described technique, in the correct patient, offers relief of symptoms 1 without compromising knee stability. 8 The role of the popliteal tendon in knee stability continues to be debated. Although we know the structure is important in native knees, 9 its role in knee stability after arthroplasty is less clear.…”

Section: Discussionmentioning

confidence: 99%

“…In a cadaveric study, resection of the popliteal tendon was not associated with knee instability in posteriorstabilized (PS) TKA implants. 8 For these reasons, resection of the popliteal tendon after TKA with PS implants may be considered safe. An alternative treatment for popliteal dysfunction in TKA would be to address the impinging lesion by either resecting the osteophyte 5 or revising the femoral component.…”

Section: Discussionmentioning

confidence: 99%

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Arthroscopic Management of Popliteal Tendon Dysfunction in Total Knee Arthroplasty

Westermann

Daniel

Callaghan

et al. 2015

Arthroscopy Techniques

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Unexplainable knee pain may follow knee replacement surgery. The popliteal tendon should be evaluated as a possible cause of lateral knee pain and dysfunction after knee arthroplasty. The tendon can snap over or impinge on lateral osteophytes or prominent femoral components and produce mechanical symptoms and pain. Ultrasound-guided injections may confirm the diagnosis and provide symptomatic relief in some patients. Those who respond well to injections and in whom conservative management ultimately fails may be offered arthroscopic release of the popliteal tendon. We present the arthroscopic technique for popliteal tendon release in a symptomatic patient whose pain resolved immediately postoperatively. We recommend the use of an anterolateral viewing portal and an accessory lateral working portal to access the posterolateral knee. There can be extensive scar tissue overlying the popliteal tendon after arthroplasty. Arthroscopic tendon transection and excision comprise a reliable procedure for popliteal tendon impingement after knee arthroplasty without compromising knee stability.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Arthroscopic Management of Popliteal Tendon Dysfunction in Total Knee Arthroplasty

Westermann

Daniel

Callaghan

et al. 2015

Arthroscopy Techniques

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“…PS prostheses may prevent some rare TKA complications, such as luxation [11], by withstanding the more stress at the PS post. By using the PS-Triathlon as previously described [10], sectioning of the popliteal tendon in our study produced excellent results and did not generate adverse effects over 3 postoperative years.…”

Section: Discussionmentioning

confidence: 60%

“…They also speculated that the popliteus might not have the same critical functions after TKA because of the combination of increased constraint in the TKA relative to the native knee and the relatively lower functional demand in this patient population. In addition, a recent experimental study [10] using the current constrained design of the PS knee replacement (PS-Triathlon) revealed that isolated sectioning of the popliteal tendon did not substantially generate abnormal knee laxity to 90° during knee flexion. PS prostheses may prevent some rare TKA complications, such as luxation [11], by withstanding the more stress at the PS post.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic Treatment of Popliteal Tendon Impingement Following Total Knee Arthroplasty: A Case Report

Soejima¹,

Katouda²

2016

J Clin Case Rep

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The popliteal tendon has been known to catch over a femoral osteophyte or the overhanging edge of the femoral component very occasionally following total knee arthroplasty (TKA). However, impingement of the popliteal tendon against the posterior edge of the tibial liner is rare. Although its pathological mechanism is simple, this complication cannot be definitively diagnosed unless posterior arthroscopic examination is performed. In this report, we describe the diagnostic and treatment challenges of using arthroscopy via posteromedial and posterolateral portals.

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“…Popliteus tendon damage has been reported in the literature with conventional knee replacements, but probably innocuous to patients [80] and also insignificant on knee laxity in particular [81]. As a result, we could consider this complication as minor, whereas the patella tendon rupture is unquestionably more serious as well as deep peroneal nerve injury which have both severe consequences and sometimes definitive impairment for patients.…”

Section: Potential Limitations Of Mismentioning

confidence: 99%

Minimally invasive total knee replacement: techniques and results

Picard

Deakin

Balasubramanian

et al. 2018

Eur J Orthop Surg Traumatol

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In this review, we outlined the definition of minimally invasive surgery (MIS) in total knee replacement (TKR) and described the different surgical approaches reported in the literature. Afterwards, we went through the most recent studies assessing MIS TKR. Next, we searched for potential limitations of MIS knee replacement and tried to answer the following questions: Are there selective criteria and specific patient selection for MIS knee surgery? If there are, then what are they? After all, a discussion and conclusion completed this article. There is certainly room for MIS or at least less invasive surgery for appropriate selected patients. Nonetheless, there are differences between approaches. Mini-medial parapatellar is easy to master, quick to perform and potentially extendable, whereas mini-subvastus and mini-midvastus are trickier and require more caution related to risk of haematoma and vastus medialis oblique (VMO) nerve damage. Current evidence on the safety and efficacy of mini-incision surgery for TKR does not appear fully adequate for the procedure to be used without special arrangements for consent and for audit or continuing research. There is an argument that a sudden jump from standard TKR to MIS TKR, especially without computer assistance such as navigation, patient-specific instrumentation or robotic, may breach a surgeon’s duty of care towards patients because it exposes patients to unnecessary risks. As a final point, more evidence is required on the long-term safety and efficacy of this procedure which will give objective shed light on real benefits of MIS TKR.

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Isolated popliteus tendon injury does not lead to abnormal laxity in posterior-stabilised total knee arthroplasty

Abstract: These findings support the view that certain current designs of PS knee replacement can constrain the knee in flexion in the absence of postero-lateral deficiency. For this implant, isolated sectioning of the popliteus tendon did not substantially generate abnormal knee laxity.

Cited by 21 publications

References 32 publications

Arthroscopic Management of Popliteal Tendon Dysfunction in Total Knee Arthroplasty

Arthroscopic Management of Popliteal Tendon Dysfunction in Total Knee Arthroplasty

Arthroscopic Treatment of Popliteal Tendon Impingement Following Total Knee Arthroplasty: A Case Report

Minimally invasive total knee replacement: techniques and results

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