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Erschienen in: Journal of Orthopaedic Science 6/2015

01.11.2015 | Original Article

Potential risk of excising the femoral insertion of the popliteus tendon during primary total knee arthroplasty: a biometric study

verfasst von: Atsushi Takahashi, Takehiko Sugita, Toshimi Aizawa, Daisuke Chiba, Masayuki Kamimura, Takashi Aki, Eiji Itoi

Erschienen in: Journal of Orthopaedic Science | Ausgabe 6/2015

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Abstract

Background

During total knee arthroplasty (TKA), excision of the popliteus tendon leads to extensive static gaps and reduced mobility. The purpose of this study was to determine the positional relationship between the femoral insertion of the popliteus tendon and the bone cutting lines of various TKA systems.

Methods

This study included 21 cadaveric right femurs presenting no macroscopic deformity. The lateral image of the femur and the template of the femoral component were overlaid to determine the preservation/excision of the popliteus tendon insertion. TKA systems used were Genesis II, NexGen, low contact stress (LCS), PFC Σ, Scorpio, and Vanguard. The knees in which the insertion was preserved in all implants or excised in at least one implant were classified into intact or the high-risk groups, respectively.

Results

The popliteus tendon was preserved in all specimens with the LCS system. In contrast, the popliteus tendon insertion was excised in ≥1/3 of the specimens with the other systems. The anteroposterior diameter was significantly larger in the intact group than that in the high-risk group (58.1 ± 4.5 mm vs. 53.7 ± 2.7 mm; p = 0.018). The high-risk group included more knees from female cadavers than the intact group (70 vs. 9 %; p = 0.008).

Conclusion

During primary TKA, the femoral insertion of the popliteus tendon could be inevitably excised, regardless of technical problems. We demonstrate that the unique design of the LCS system preserves the popliteus tendon insertion. In addition, small knees and females may be risk factors for excision of the insertion.
Literatur
1.
Zurück zum Zitat LaPrade RF, Wozniczka JK, Stellmaker MP, Wijdicks CA. Analysis of the static function of the popliteus tendon and evaluation of an anatomic reconstruction: the “fifth ligament” of the knee. Am J Sports Med. 2010;38(3):543–9.CrossRefPubMed LaPrade RF, Wozniczka JK, Stellmaker MP, Wijdicks CA. Analysis of the static function of the popliteus tendon and evaluation of an anatomic reconstruction: the “fifth ligament” of the knee. Am J Sports Med. 2010;38(3):543–9.CrossRefPubMed
2.
Zurück zum Zitat Pasque C, Noyes FR, Gibbons M, Levy M, Grood E. The role of the popliteofibular ligament and the tendon of popliteus in providing stability in the human knee. J Bone Jt Surg Br. 2003;85(2):292–8.CrossRef Pasque C, Noyes FR, Gibbons M, Levy M, Grood E. The role of the popliteofibular ligament and the tendon of popliteus in providing stability in the human knee. J Bone Jt Surg Br. 2003;85(2):292–8.CrossRef
3.
Zurück zum Zitat Tria AJ Jr, Johnson CD, Zawadsky JP. The popliteus tendon. J Bone Jt Surg Am. 1989;71(5):714–6. Tria AJ Jr, Johnson CD, Zawadsky JP. The popliteus tendon. J Bone Jt Surg Am. 1989;71(5):714–6.
4.
Zurück zum Zitat Basmajian JV, Lovejoy JF Jr. Functions of the popliteus muscle in man. A multifactorial electromyographic study. J Bone Jt Surg Am. 1971;53(3):557–62. Basmajian JV, Lovejoy JF Jr. Functions of the popliteus muscle in man. A multifactorial electromyographic study. J Bone Jt Surg Am. 1971;53(3):557–62.
5.
Zurück zum Zitat Tantavisut S, Tanavalee A, Ngarmukos S, Limtrakul A, Wilairatana V, Wangroongsub Y. Gap changes after popliteus-tendon resection in PS-TKA: a cadaveric study in Thai female knees. Knee. 2012;19(5):597–600.CrossRefPubMed Tantavisut S, Tanavalee A, Ngarmukos S, Limtrakul A, Wilairatana V, Wangroongsub Y. Gap changes after popliteus-tendon resection in PS-TKA: a cadaveric study in Thai female knees. Knee. 2012;19(5):597–600.CrossRefPubMed
6.
Zurück zum Zitat Peters CL, Severson E, Crofoot C, Allen B, Erickson J. Popliteus tendon release in the varus or neutral knee: prevalence and potential etiology. J Bone Jt Surg Am. 2008;90(Suppl 4):40–6.CrossRef Peters CL, Severson E, Crofoot C, Allen B, Erickson J. Popliteus tendon release in the varus or neutral knee: prevalence and potential etiology. J Bone Jt Surg Am. 2008;90(Suppl 4):40–6.CrossRef
7.
Zurück zum Zitat Kanamiya T, Whiteside LA, Nakamura T, Mihalko WM, Steiger J, Naito M. Ranawat award paper. Effect of selective lateral ligament release on stability in knee arthroplasty. Clin Orthop Relat Res. 2002;404:24–31.CrossRefPubMed Kanamiya T, Whiteside LA, Nakamura T, Mihalko WM, Steiger J, Naito M. Ranawat award paper. Effect of selective lateral ligament release on stability in knee arthroplasty. Clin Orthop Relat Res. 2002;404:24–31.CrossRefPubMed
8.
Zurück zum Zitat de Simone V, Demey G, Magnussen RA, Lustig S, Servien E, Neyret P. Iatrogenic popliteus tendon injury during total knee arthroplasty results in decreased knee function two to three years postoperatively. Int Orthop. 2012;36(10):2061–5.PubMedCentralCrossRefPubMed de Simone V, Demey G, Magnussen RA, Lustig S, Servien E, Neyret P. Iatrogenic popliteus tendon injury during total knee arthroplasty results in decreased knee function two to three years postoperatively. Int Orthop. 2012;36(10):2061–5.PubMedCentralCrossRefPubMed
9.
Zurück zum Zitat Nyland J, Lachman N, Kocabey Y, Brosky J, Altun R, Caborn D. Anatomy, function, and rehabilitation of the popliteus musculotendinous complex. J Orthop Sports Phys Ther. 2005;35(3):165–79.CrossRefPubMed Nyland J, Lachman N, Kocabey Y, Brosky J, Altun R, Caborn D. Anatomy, function, and rehabilitation of the popliteus musculotendinous complex. J Orthop Sports Phys Ther. 2005;35(3):165–79.CrossRefPubMed
10.
Zurück zum Zitat Takeda S, Tajima G, Fujino K, Yan J, Kamei Y, Maruyama M, et al. (2014) Morphology of the femoral insertion of the lateral collateral ligament and popliteus tendon. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-014-3059-5. Takeda S, Tajima G, Fujino K, Yan J, Kamei Y, Maruyama M, et al. (2014) Morphology of the femoral insertion of the lateral collateral ligament and popliteus tendon. Knee Surg Sports Traumatol Arthrosc. doi:10.​1007/​s00167-014-3059-5.
11.
Zurück zum Zitat Fok AW, Kuang GM, Yau WP. Femoral radiographic landmarks for popliteus tendon reconstruction and repair: a new method of reference. Am J Sports Med. 2014;42(2):394–8.CrossRefPubMed Fok AW, Kuang GM, Yau WP. Femoral radiographic landmarks for popliteus tendon reconstruction and repair: a new method of reference. Am J Sports Med. 2014;42(2):394–8.CrossRefPubMed
12.
Zurück zum Zitat Jung GH, Kim JD, Kim H. Location and classification of popliteus tendon’s origin: cadaveric study. Arch Orthop Trauma Surg. 2010;130(8):1027–32.CrossRefPubMed Jung GH, Kim JD, Kim H. Location and classification of popliteus tendon’s origin: cadaveric study. Arch Orthop Trauma Surg. 2010;130(8):1027–32.CrossRefPubMed
13.
Zurück zum Zitat Kamath GV, Redfern JC, Burks RT. Femoral radiographic landmarks for lateral collateral ligament reconstruction and repair: a new method of reference. Am J Sports Med. 2010;38(3):570–4.CrossRefPubMed Kamath GV, Redfern JC, Burks RT. Femoral radiographic landmarks for lateral collateral ligament reconstruction and repair: a new method of reference. Am J Sports Med. 2010;38(3):570–4.CrossRefPubMed
14.
Zurück zum Zitat LaPrade RF, Ly TV, Wentorf FA, Engebretsen L. The posterolateral attachments of the knee: a qualitative and quantitative morphologic analysis of the fibular collateral ligament, popliteus tendon, popliteofibular ligament, and lateral gastrocnemius tendon. Am J Sports Med. 2003;31(6):854–60.PubMed LaPrade RF, Ly TV, Wentorf FA, Engebretsen L. The posterolateral attachments of the knee: a qualitative and quantitative morphologic analysis of the fibular collateral ligament, popliteus tendon, popliteofibular ligament, and lateral gastrocnemius tendon. Am J Sports Med. 2003;31(6):854–60.PubMed
15.
Zurück zum Zitat Pietrini SD, LaPrade RF, Griffith CJ, Wijdicks CA, Ziegler CG. Radiographic identification of the primary posterolateral knee structures. Am J Sports Med. 2009;37(3):542–51.CrossRefPubMed Pietrini SD, LaPrade RF, Griffith CJ, Wijdicks CA, Ziegler CG. Radiographic identification of the primary posterolateral knee structures. Am J Sports Med. 2009;37(3):542–51.CrossRefPubMed
16.
Zurück zum Zitat Yang JH, Lim HC, Bae JH, Fernandez H, Bae TS, Wang JH. Anatomic and isometric points on femoral attachment site of popliteus muscle-tendon complex for the posterolateral corner reconstruction. Knee Surg Sports Traumatol Arthrosc. 2011;19(10):1669–74.CrossRefPubMed Yang JH, Lim HC, Bae JH, Fernandez H, Bae TS, Wang JH. Anatomic and isometric points on femoral attachment site of popliteus muscle-tendon complex for the posterolateral corner reconstruction. Knee Surg Sports Traumatol Arthrosc. 2011;19(10):1669–74.CrossRefPubMed
17.
Zurück zum Zitat Yoshioka Y, Siu D, Cooke TD. The anatomy and functional axes of the femur. J Bone Joint Surg Am. 1987;69(6):873–80.PubMed Yoshioka Y, Siu D, Cooke TD. The anatomy and functional axes of the femur. J Bone Joint Surg Am. 1987;69(6):873–80.PubMed
18.
Zurück zum Zitat Lustig S, Lavoie F, Selmi TA, Servien E, Neyret P. Relationship between the surgical epicondylar axis and the articular surface of the distal femur: an anatomic study. Knee Surg Sports Traumatol Arthrosc. 2008;16(7):674–82.CrossRefPubMed Lustig S, Lavoie F, Selmi TA, Servien E, Neyret P. Relationship between the surgical epicondylar axis and the articular surface of the distal femur: an anatomic study. Knee Surg Sports Traumatol Arthrosc. 2008;16(7):674–82.CrossRefPubMed
19.
Zurück zum Zitat Schneider CA, Rasband WS, Eliceiri KW. NIH Image to ImageJ: 25 years of image analysis. Nat Methods. 2012;9(7):671–5.CrossRefPubMed Schneider CA, Rasband WS, Eliceiri KW. NIH Image to ImageJ: 25 years of image analysis. Nat Methods. 2012;9(7):671–5.CrossRefPubMed
20.
Zurück zum Zitat Kesman TJ, Kaufman KR, Trousdale RT. Popliteus tendon resection during total knee arthroplasty: an observational report. Clin Orthop Relat Res. 2011;469(1):76–81.PubMedCentralCrossRefPubMed Kesman TJ, Kaufman KR, Trousdale RT. Popliteus tendon resection during total knee arthroplasty: an observational report. Clin Orthop Relat Res. 2011;469(1):76–81.PubMedCentralCrossRefPubMed
Metadaten
Titel
Potential risk of excising the femoral insertion of the popliteus tendon during primary total knee arthroplasty: a biometric study
verfasst von
Atsushi Takahashi
Takehiko Sugita
Toshimi Aizawa
Daisuke Chiba
Masayuki Kamimura
Takashi Aki
Eiji Itoi
Publikationsdatum
01.11.2015
Verlag
Springer Japan
Erschienen in
Journal of Orthopaedic Science / Ausgabe 6/2015
Print ISSN: 0949-2658
Elektronische ISSN: 1436-2023
DOI
https://doi.org/10.1007/s00776-015-0773-x

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