Surgical management of isolated popliteus tendon injuries in paediatric patients

Liu, Joseph N.; Rebolledo, Brian J.; Warren, Russell F.; Green, Daniel W.

doi:10.1007/s00167-016-4029-x

Cited by 8 publications

(11 citation statements)

References 21 publications

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“…24 However, nonoperative rehabilitation protocols remain largely heterogenous with little specificity. 24 Meanwhile, operative management has been recommended in patients with popliteus tendon injuries associated with an avulsed osteochondral fragment off the femoral attachment 13,18,33 and in patients with PLC instability 14 restore popliteal function while preserving the native kinematics of the knee. As such, isolated injuries to the popliteus in athletes should be tailored to the individual athlete, and further studies are warranted to identify athlete- and injury-specific variables predictive of improved outcomes and RTS based on management.…”

Section: Discussionmentioning

confidence: 99%

Prevalence, Mechanisms, and Return to Sport After Isolated Popliteus Injuries in Athletes: A Systematic Review

Morrissey

Knapik

2022

Orthopaedic Journal of Sports Medicine

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Background: Injuries to the posterolateral corner of the knee are commonly reported in athletes, although the prevalence of isolated injuries to the popliteus in athletes is largely unknown. Purpose: To systematically review the literature to better understand the prevalence, mechanisms, sporting activities, tear characteristics, management, outcomes, and return-to-sport rate and timing in athletes who have sustained isolated popliteus injuries. Study Design: Systematic review; Level of evidence, 4. Methods: Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, the authors searched the PubMed, OVID, MEDLINE, Biosis Previews, SPORTDiscus, PEDRO, and EMBASE databases for studies from January 1988 to August 2021 on athletes who sustained isolated popliteus injuries during sporting activities. Results: A total of 19 studies consisting of 27 athletes with isolated popliteus injuries sustained during sport were identified. The mean athlete age was 19.9 ± 10.5 years, while 89% (n = 24/27) were male. Traumatic/contact mechanisms were reported in 67% (n = 18/27) of injuries, with American football and soccer being the most common sports. Lateral-sided knee pain was the most frequent complaint, with 85% (n = 23/27) of athletes reporting swelling. Avulsion injuries off the lateral condyle were present in 67% (n = 18/27) of cases. Nonoperative management was performed in 52% (n = 14/27) of athletes. Operative treatment consisted primarily of arthroscopic or open fixation of the osseous fragment. When reported, all athletes successfully returned to sport at a mean of 10.8 ± 8.2 weeks after injury. Conclusion: Isolated injuries to the popliteus remain rarely reported in athletes, and athletes are typically evaluated after they experience forced external rotation of the tibia relative to the femur, present with lateral-sided knee pain and effusion, and undergo a stable ligamentous examination. Injuries occurred primarily in male athletes and were the result of traumatic/contact mechanisms, most commonly involving avulsion injuries off the lateral femoral condyle.

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Section: Discussionmentioning

confidence: 99%

Prevalence, Mechanisms, and Return to Sport After Isolated Popliteus Injuries in Athletes: A Systematic Review

Morrissey

Knapik

2022

Orthopaedic Journal of Sports Medicine

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“…Both surgical and nonoperative management have been suggested in cases both with and without clinical exam findings consistent with PLC insufficiency. 7 , 8 , 9 A risk of nonoperative treatment is development of a bony bridge resulting in progressive valgus deformity requiring late osteotomy. 1 Methods of operative fixation vary from suture repair over a bony bridge, suture repair with suture anchors, and repair with screws and washers.…”

Section: Discussionmentioning

confidence: 99%

“… 1 Methods of operative fixation vary from suture repair over a bony bridge, suture repair with suture anchors, and repair with screws and washers. 3 , 8 , 9 , 10 …”

Section: Discussionmentioning

confidence: 99%

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Double-Row Suture Anchor Repair of Posterolateral Corner Avulsion Fractures

Gilmer

2017

Arthroscopy Techniques

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Posterolateral corner avulsion fractures are a rare variant of ligamentous knee injury primarily described in the skeletally immature population. Injury is often related to a direct varus moment placed on the knee during sporting activities. Various treatment strategies have been discussed ranging from nonoperative management, to excision of the bony fragment, to primary repair with screws or suture. The described technique is a means for achieving fixation of the bony avulsion using principles familiar to double-row transosseous equivalent rotator cuff repair. Proximal anchors are placed in the epiphysis, and sutures are passed in horizontal mattress fashion. Once tied, the limbs of these same sutures are then passed to more distal anchors. Remaining eyelet sutures can be used to manage peripheral tissue. The final repair provides anatomic reduction and compression of the fragment to its bony bed with minimal extracortical hardware prominence and no violation of the physis. Risks include potential for physeal injury or chondral damage to the lateral femoral condyle through aberrant anchor placement. Postoperative care includes toe-touch weight-bearing restrictions and range of motion restrictions of 0°-90° in a hinged brace for 6 weeks followed by gradual return to activity.

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“…However, in extraarticular cases, open surgery can be necessary depending on the level of stumps retraction. In avulsion injuries, it is necessary to fix the tendon the attachment site using a screw or anchor [7,29,31].…”

Section: Anatomical Implications Into Treatmentmentioning

confidence: 99%

Current concepts on the morphology of popliteus tendon and its clinical implications

et al. 2021

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In this review we described the anatomy and biomechanics of popliteus muscle and its tendon. Furthermore, we combined the anatomy with clinics and discussed a wide spectrum of disorders regarding the popliteus and its musculotendinous complex.There are three main anatomical regions of the popliteus musculotendinous complex: the proximal origin, the mid-portion, the distal part on the tibia. The unique localization and various origins of the tendon, connected with structures such as fibular head, Wrisberg, Humphrey and posterior cruciate ligament, lateral meniscus, medial collateral ligament, give an implication to diagnosis and treatment. Popliteus dysfunction is often overlooked, that is the reason why diagnosis and treatment of its injuries is mostly insufficient.Repetitive or acute direct varus force, when the tibia is in external rotation, and knee hyperextension or flexion with forced external rotation of the tibia, are the main mechanisms of trauma. Popliteus injuries mainly affect the athletic population and lead to severe activity limitations. Chronic disorders of the popliteus tendon, less known, are often described as tendinopathy and are frequently seen in runners. Their symptoms can mimic the lateral meniscal tears. On the other hand, high-energy traumatic injuries of the popliteus tendon often accompany complex, multi ligamentous injuries seen in competitive sports. We also presented the implication of popliteus tendon in knee arthroplasty, due to its particular exposition to iatrogenic trauma during surgery. The issues such as proper tibial component location and well-designed cut systems are crucial to avoid the popliteus impingement and preserve its structure.

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Surgical management of isolated popliteus tendon injuries in paediatric patients

Cited by 8 publications

References 21 publications

Prevalence, Mechanisms, and Return to Sport After Isolated Popliteus Injuries in Athletes: A Systematic Review

Prevalence, Mechanisms, and Return to Sport After Isolated Popliteus Injuries in Athletes: A Systematic Review

Double-Row Suture Anchor Repair of Posterolateral Corner Avulsion Fractures

Current concepts on the morphology of popliteus tendon and its clinical implications

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