Popliteus Tendon Resection During Total Knee Arthroplasty: An Observational Report

Abstract

Background The contribution provided by the popliteus tendon in patients undergoing TKA is poorly defined. Some authors believe the popliteus tendon is essential to a well-functioning arthroplasty, while others do not believe it provides a critical function. Questions/purposes The purposes of this study were to (1) evaluate the effect of resecting the popliteus tendon on knee ligament balancing in extension and flexion intraoperatively during posterior stabilized TKA; and (2) evaluate the effect of resecting the popliteus tendon on load distribution on the tibial plateau as determined by an in vitro single limb stance model during TKA. Methods We randomized 18 patients scheduled for a TKA into two groups, A and B. Once component trials were in place, the senior surgeon removed himself from the operating table to allow for a blinded trial. The first assistant then cut the popliteus tendon in Group A patients but not in Group B patients. The senior surgeon then returned to the table to reevaluate the subjective balance of the ligamentous structures of the knee in both extension and in flexion. A parallel cadaveric study was also completed using a sophisticated instrumented tibial plateau sensor in three knees.

Arthroscopic Management of Popliteal Tendon Dysfunction in Total Knee Arthroplasty

“…The popliteal tendon is commonly released during balancing for coronal deformity. In a blinded study, Kesman et al 10 showed equivalent outcomes in patients undergoing TKA with and without release of the popliteal tendon. In a cadaveric study, resection of the popliteal tendon was not associated with knee instability in posteriorstabilized (PS) TKA implants.…”

Sectional Anatomy and Three‐Dimensional Visualization of the Posterolateral Complex of the Knee Joint Based on Undeformed High‐Resolution Sectional Anatomical Images

“…Because the popliteus muscle connects to the PT, it shows great flexibility in effectively inhibiting knee varus instability while bending the knee from 0° to 90° (Nielsen and Helmig, ). However, some studies have shown that resection of the PT does not change the static balance of the knee, suggesting that the PT is not the main static stabilizer outside the tibia (Kesman et al, ; Thaunat et al, ). Some studies propose that reconstruction of the PLC without reconstructing the PT can also achieve stability of the knee (Apsingi et al, ; Yoon et al, ).…”

Diagnosing and Treating Popliteal Tendinopathy After Total Knee Arthroplasty

“…Although assessing a different outcome, these results appear to differ from Kesman et. al., who prospectively enrolled eighteen patients to randomly have their popliteal tendon released by the first assistant, while the senior surgeon was blinded to the presence or absence of the release [10]. The senior surgeon, with trials in place, would assess ligamentous stability.…”