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Popliteus Tendon Resection During Total Knee Arthroplasty: An Observational Report

  • Symposium: Papers Presented at the Annual Meetings of the Knee Society
  • Published:
Clinical Orthopaedics and Related Research®

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.

Results

The senior surgeon was unable to detect a difference in the knee stability between knees with transected popliteal tendons and those with intact popliteal tendons. In vitro studies showed there was no change in load distribution between the medial and lateral plateaus once the popliteus tendon was transected.

Conclusions

Resection of the popliteus tendon does not appear to change the static balance of the knee.

Level of Evidence

Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.

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Acknowledgments

We thank all participants of the study and those individuals who assisted us in completing this study including Ms. Emily Miller, Dr. Rafael Sierra, and Dr. Mark Pagnano.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Thomas J. Kesman MD, MBA, Kenton R. Kaufman PhD & Robert T. Trousdale MD

Authors
  1. Thomas J. Kesman MD, MBA
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  2. Kenton R. Kaufman PhD
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  3. Robert T. Trousdale MD
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Corresponding author

Correspondence to Robert T. Trousdale MD.

Additional information

Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his or her institution approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

Appendix

Appendix

Data Forms and Flowcharts Used for Study

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Kesman, T.J., Kaufman, K.R. & Trousdale, R.T. Popliteus Tendon Resection During Total Knee Arthroplasty: An Observational Report. Clin Orthop Relat Res 469, 76–81 (2011). https://doi.org/10.1007/s11999-010-1525-z

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  • DOI: https://doi.org/10.1007/s11999-010-1525-z

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