title: The role of the popliteus tendon in total knee arthroplasty: a cadaveric study: SIGASCOT Best Paper Award Finalist 2014.
abstract: OBJECTIVE
  this study was conducted to investigate the influence of the popliteus tendon (PT) on the static stability of total knee arthroplasty (TKA).
  
  
  METHODS
  twenty knees were used. In 10 right knees, a cruciate-retaining (CR) TKA trial prosthesis was implanted; in the other ten knees (left knees), the posterior cruciate ligament was cut and a posterior substitution (PS) TKA trial prosthesis was implanted. Lamina spreaders were set at 100 N of tension, one on the medial and one on the lateral articular space. Gaps were then measured with a caliper before and after PT sectioning.
  
  
  RESULTS
  the correlation between femoral dimensions and popliteus insertion distance from articular surfaces was measured with the Pearson correlation index and considered significant. In the CR-TKA group, medial and lateral gap measurements showed a significant increase after PT sectioning both in flexion and in extension. In the PS-TKA group, lateral gap measurements showed a significant increase after PT sectioning both in flexion and in extension, while the medial gap measurements increased significantly only in flexion.
  
  
  CONCLUSIONS
  PT sectioning destabilized both the lateral and the medial aspects of the knee. A greater effect was observed in the lateral compartment. The most statistically reliable effect was observed with the knee in flexion. In addition, we observed that preserving the PCL does not prevent lateral gap opening after PT sectioning.
  
  
  CONCLUSIONS
  PT should always be preserved when performing a TKA, because its resection can affect gap balancing, in flexion and in extension.
  
  
  METHODS
  controlled laboratory study.
authors.affiliation: Department of Orthopaedics, Mauriziano Umberto I Hospital Torino, Italy.
authors.forename: Umberto
authors.initials: U
authors.lastname: Cottino
authors.affiliation: Department of Orthopaedics, Mauriziano Umberto I Hospital Torino, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Bruzzone
authors.affiliation: Department of Orthopaedics, Mauriziano Umberto I Hospital Torino, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Rosso
authors.affiliation: Department of Orthopaedics, Mauriziano Umberto I Hospital Torino, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Dettoni
authors.affiliation: Department of Orthopaedics, Mauriziano Umberto I Hospital Torino, Italy.
authors.forename: Davide Edoardo
authors.initials: DE
authors.lastname: Bonasia
authors.affiliation: Department of Orthopaedics, Mauriziano Umberto I Hospital Torino, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Rossi
keywords: knee instability; knee revision; knee soft tissue balancing; popliteus tendon; total knee arthroplasty