Top

Knee Surgery, Sports Traumatology, Arthroscopy

Published in:

01-12-2017 | Knee

Femoral footprint of the popliteus tendon may be at the risk of damage during total knee arthroplasty

Authors: Takashi Aki, Takehiko Sugita, Atsushi Takahashi, Toshimi Aizawa, Masayuki Kamimura, Akira Sasaki, Naohisa Miyatake, Eiji Itoi

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 12/2017

Abstract

Purpose

The present study focused on the prevalence of incidental excision of the femoral footprint of the popliteus tendon during total knee arthroplasty and its associated risk factors.

Methods

A total of 275 knee arthroplasties were performed for 226 patients with varus knee osteoarthritis. The status of the femoral footprint of the popliteus tendon was intraoperatively evaluated and classified into three groups (preserved, partially excised, and completely excised), and the prevalence of the excision was identified. Femoral component size, the thickness of the resected distal femoral condyle, and preoperative patient demographic data were compared for the three groups. Ordinal logistic regression analysis was performed to reveal risk factors associated with the excision.

Results

The femoral footprint of the popliteus tendon was preserved in 132 knees (48.0 %), partially excised in 94 knees (34.2 %) and completely excised in 49 knees (17.8 %). The ordinal logistic regression analysis revealed thicker resection of the distal femoral condyle (p < 0.0001) and shorter body height (p = 0.0266) to be the independent risk factors for the excision.

Conclusions

The incidental partial or complete excision of the femoral footprint of the popliteus tendon was identified in approximately half of the evaluated knees. Thicker resection of the distal femoral condyle and shorter body height were the most significant risk factors for the excision.

Level of evidence

Case–control study, Level III.

Brinkman JM, Schwering PJ, Blankevoort L, Kooloos JG, Luites J, Wymenga AB (2005) The insertion geometry of the posterolateral corner of the knee. J Bone Joint Surg Br 87:1364–1368CrossRefPubMed

de Simone V, Demey G, Magnussen RA, Lustig S, Servien E, Neyret P (2012) Iatrogenic popliteus tendon injury during total knee arthroplasty results in decreased knee function two to three years postoperatively. Int Orthop 36:2061–2065CrossRefPubMedPubMedCentral

Ferrari DA, Wilson DR, Hayes WC (2003) The effect of release of the popliteus and quadriceps force on rotation of the knee. Clin Orthop Relat Res 412:225–233CrossRef

Fok AW, Kuang GM, Yau WP (2014) Femoral radiographic landmarks for popliteus tendon reconstruction and repair: a new method of reference. Am J Sports Med 42:394–398CrossRefPubMed

Ghosh KM, Blain AP, Longstaff L, Rushton S, Amis AA, Deehan DJ (2014) Can we define envelope of laxity during navigated knee arthroplasty? Knee Surg Sports Traumatol Arthrosc 22:1736–1743CrossRefPubMed

Ghosh KM, Hunt N, Blain A, Athwal KK, Longstaff L, Amis AA et al (2015) Isolated popliteus tendon injury does not lead to abnormal laxity in posterior-stabilized total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 23:1763–1769CrossRefPubMed

Jung GH, Kim JD, Kim H (2010) Location and classification of popliteus tendon’s origin: cadaveric study. Arch Orthop Trauma Surg 130:1027–1032CrossRefPubMed

Kazakin A, Nandi S, Bono J (2014) Diagnosis and treatment of intraoperative tendon impingement. J Knee Surg 27:485–488CrossRefPubMed

Kesman TJ, Kaufman KR, Trousdale RT (2011) Popliteus tendon resection during total knee arthroplasty: an observational report. Clin Orthop Relat Res 469:76–81CrossRefPubMed

10.

LaPrade RF, Ly TV, Wentorf FA, Engebretsen L (2003) The posterolateral attachments of the knee: a qualitative and quantitative morphologic analysis of the fibular collateral ligament, popliteus tendon, popliteofibular ligament, and lateral gastrocnemius tendon. Am J Sports Med 31:854–860CrossRefPubMed

11.

LaPrade RF, Wozniczka JK, Stellmaker MP, Wijdicks CA (2010) Analysis of the static function of the popliteus tendon and evaluation of an anatomic reconstruction: the “fifth ligament” of the knee. Am J Sports Med 38:543–549CrossRefPubMed

12.

Pasque C, Noyes FR, Gibbons M, Levy M, Grood E (2003) The role of the popliteofibular ligament and the tendon of popliteus in providing stability in the human knee. J Bone Joint Surg Br 85:292–298CrossRefPubMed

13.

Peters CL, Severson E, Crofoot C, Allen B, Erickson J (2008) Popliteus tendon release in the varus or neutral knee: prevalence and potential etiology. J Bone Joint Surg Am 90(Suppl 4):40–46CrossRefPubMed

14.

Pietrini SD, LaPrade RF, Griffith CJ, Wijdicks CA, Ziegler CG (2009) Radiographic identification of the primary posterolateral knee structures. Am J Sports Med 37:542–551CrossRefPubMed

15.

Takahashi A, Sugita T, Aizawa T, Chiba D, Kamimura M, Aki T, Itoi E (2015) Potential risk of excising the femoral insertion of the popliteus tendon during primary total knee arthroplasty: a biometric study. J Orthop Sci 20:1030–1035CrossRefPubMed

16.

Takeda S, Tajima G, Fujino K, Yan J, Kamei Y, Maruyama M et al (2014) Morphology of the femoral insertion of the lateral collateral ligament and popliteus tendon. Knee Surg Sports Traumatol Arthrosc 23:3049–3054CrossRefPubMed

17.

Tantavisut S, Tanavalee A, Ngarmukos S, Limtrakul A, Wilairatana V, Wangroongsub Y (2012) Gap changes after popliteus-tendon resection in PS-TKA: a cadaveric study in Thai female knees. Knee 19:597–600CrossRefPubMed

18.

Ullrich K, Krudwig WK, Witzel U (2002) Posterolateral aspect and stability of the knee joint. I. Anatomy and function of the popliteus muscle-tendon unit: an anatomical and biomechanical study. Knee Surg Sports Traumatol Arthrosc 10:86–90CrossRefPubMed

19.

Watanabe Y, Moriya H, Takahashi K, Yamagata M, Sonoda M, Shimada Y et al (1993) Functional anatomy of the posterolateral structures of the knee. Arthroscopy 9:57–62CrossRefPubMed

20.

Yang JH, Lim HC, Bae JH, Fernandez H, Bae TS, Wang JH (2011) Anatomic and isometric points on femoral attachment site of popliteus muscle-tendon complex for the posterolateral corner reconstruction. Knee Surg Sports Traumatol Arthrosc 19:1669–1674CrossRefPubMed

Title: Femoral footprint of the popliteus tendon may be at the risk of damage during total knee arthroplasty
Authors: Takashi Aki
Takehiko Sugita
Atsushi Takahashi
Toshimi Aizawa
Masayuki Kamimura
Akira Sasaki
Naohisa Miyatake
Eiji Itoi
Publication date: 01-12-2017
Publisher: Springer Berlin Heidelberg
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 12/2017
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-016-4177-z

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Femoral footprint of the popliteus tendon may be at the risk of damage during total knee arthroplasty

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

Please log in to get access to this content

Other articles of this Issue 12/2017

Balancing mobile-bearing unicondylar knee arthroplasty in vitro

Knee joint preservation: a call for daily practice revival of realignment surgery and osteotomies around the knee

Erratum to: The C-reactive protein level after total knee arthroplasty is gender specific

Conceptual and methodological considerations in the assessment of the neuromuscular function by means of tensiomyography

Adolescents and female patients are at increased risk for contralateral anterior cruciate ligament reconstruction: a cohort study from the Swedish National Knee Ligament Register based on 17,682 patients

Articular cartilage paste graft for severe osteochondral lesions of the knee: a 10- to 23-year follow-up study