Document Detail

Popliteus tendon resection during total knee arthroplasty: an observational report.
MedLine Citation:
PMID:  20809169     Owner:  NLM     Status:  MEDLINE    
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.
Thomas J Kesman; Kenton R Kaufman; Robert T Trousdale
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Publication Detail:
Type:  In Vitro; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  469     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2010-12-24     Completed Date:  2011-01-25     Revised Date:  2013-05-28    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  76-81     Citation Subset:  AIM; IM    
Department of Orthopaedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
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MeSH Terms
Aged, 80 and over
Arthroplasty, Replacement, Knee* / adverse effects,  instrumentation
Joint Instability / etiology
Knee Joint / physiopathology,  surgery*
Knee Prosthesis
Ligaments, Articular / physiopathology,  surgery*
Middle Aged
Prosthesis Design
Recovery of Function
Tendons / physiopathology,  surgery*
Time Factors
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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