To relieve pain and improve patient satisfaction with the TKA procedure, arthroscopic popliteal tenotomy can be performed. However, very little data exists to suggest that following TKA, any pain experienced may be associated with popliteus tendon impingement.
A study has been undertaken to estimate the prevalence of popliteus tendon impingement following TKA, and to describe the characteristics and treatment of this rare condition. Of well over 700 patients who received TKA over three years, only eight had suspected popliteus tendon impingement. Although this is a relatively small number the condition results in very severe localised posterolateral knee pain for most, and global knee pain for one of the patients in the study group.
All of the patients being studied underwent additional routine investigations to confirm proper implant positioning and sizing, as well as tests to rule out any other conditions or causes such as sciata, low back pain and infections. A popliteus test carried out on all 8 patients showed that the popliteus tendon was extremely tight and clearly impinging against the superior border of the posterolateral corner of the polyethylene insert.
An arthroscopic popliteal tenotomy was performed and full weight-bearing and daily activities were allowed without any restrictions post operation. The procedure resulted in a very high satisfaction rate suggesting that the popliteus test is reliable to diagnose popliteus tendon impingement following TKA, which can then be treated by arthroscopic popliteal tenotomy.