Popliteus tendon resection during total knee arthroplasty: an observational report.
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.


OBJECTIVE
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.


METHODS
Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.
Kesman
Thomas J
TJ
Department of Orthopaedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Kaufman
Kenton R
KR
Trousdale
Robert T
RT
D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000295:instrumentation; D002102:Cadaver; D006801:Humans; D066298:In Vitro Techniques; D007593:Joint Instability / Q000209:etiology; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery*; D007720:Knee Prosthesis; D008023:Ligaments, Articular / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D011474:Prosthesis Design; D020127:Recovery of Function; D013710:Tendons / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D016474:Weight-Bearing
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