Arthroscopic Management of Popliteal Tendon Dysfunction in Total Knee Arthroplasty

Unexplainable knee pain may follow knee replacement surgery. The popliteal tendon should be evaluated as a possible cause of lateral knee pain and dysfunction after knee arthroplasty. The tendon can snap over or impinge on lateral osteophytes or prominent femoral components and produce mechanical symptoms and pain. Ultrasound-guided injections may confirm the diagnosis and provide symptomatic relief in some patients. Those who respond well to injections and in whom conservative management ultimately fails may be offered arthroscopic release of the popliteal tendon. We present the arthroscopic technique for popliteal tendon release in a symptomatic patient whose pain resolved immediately postoperatively. We recommend the use of an anterolateral viewing portal and an accessory lateral working portal to access the posterolateral knee. There can be extensive scar tissue overlying the popliteal tendon after arthroplasty. Arthroscopic tendon transection and excision comprise a reliable procedure for popliteal tendon impingement after knee arthroplasty without compromising knee stability.