scholarly journals Two cases of chronic knee pain caused by unusual injuries to the popliteus tendon

Joints ◽  
2016 ◽  
Vol 04 (01) ◽  
pp. 062-064
Author(s):  
Eric Davalos ◽  
David Barank ◽  
Rajeev Varma
Keyword(s):  
Knee Pain ◽  
Femoral Condyle ◽  
Insertion Site ◽  
Joint Space ◽  
Lateral Femoral Condyle ◽  
Popliteus Tendon ◽  
Musculotendinous Junction ◽  
Chronic Knee Pain

Injuries to the popliteus tendon are less frequent than injuries to the menisci or ligamentous structures of the knee. When they do occur, injuries to the popliteus tendon tend to be the result of trauma and associated with injuries to other components of the knee. The most commonly seen injuries include tears at the musculotendinous junction and avulsion tears at the lateral femoral condyle insertion site. This report presents two unusual injuries of the popliteus tendon in pa tients with chronic knee pain: an isolated split tear of the tendon and a subluxed tendon residing within the lateral joint space.

Postero-anterior radiogram of the knee in weight-bearing and semiflexion

1997 ◽  
Vol 38 (6) ◽  
pp. 1063-1070 ◽  
Author(s):  
T. Boegård ◽  
O. Rudling ◽  
I. F. Petersson ◽  
J. Sanfridsson ◽  
T. Saxne ◽  
...  
Keyword(s):  
Joint Space Narrowing ◽  
Spin Echo ◽  
Femoral Condyle ◽  
Weight Bearing ◽  
Joint Space ◽  
Cartilage Defects ◽  
Proton Density ◽  
Turbo Spin Echo ◽  
Chronic Knee Pain ◽  
Width Measurements

Purpose: the purpose was four-fold: to assess the reproducibility of p.a. weight-bearing radiograms of the knee and the minimal joint-space (MJS) width measurements in these radiograms; to compare the MJS with MR-detected cartilage defects; to evaluate the location of these cartilage defects; and to estimate the relation between meniscal abnormalities and joint-space narrowing Material and Methods: Fifty-nine individuals, aged 41–58 years (mean 50), with chronic knee pain were examined by means of p.a. weight-bearing radiograms in semi-flexion with fluoroscopic guidance of the knee joint. the MJS was measured with a standard ruler. on the same day MR imaging was performed with proton-density- and T2-weighted turbo spin-echo on a 1.0 T imager. Meniscal abnormalities and cartilage defects in the tibiofemoral joint (TFJ) were noted Results and Conclusion: the p.a. view of the knee and the MJS measurements were reproducible. MJS of 3 mm is a limit in diagnosing joint-space narrowing in knees with MR-detected cartilage defects. There was a high proportion <p<0.001) of meniscal abnormality within the narrowed compartments in comparison with those that were not narrowed. A larger number of the cartilage defects (p<0.05) was found in the medial femoral condyle than in any of the other condyles of the TFJ. the defects had a dorsal location <p<0.001) as shown in the weight-bearing radiograms of the knee in semiflexion

Joint-space width in the axial view of the patello-femoral joint

1998 ◽  
Vol 39 (1) ◽  
pp. 24-31 ◽  
Author(s):  
T. Boegård ◽  
O. Rudling ◽  
I. F. Petersson ◽  
J. Sanfridsson ◽  
T. Saxne ◽  
...  
Keyword(s):  
Knee Pain ◽  
Joint Space Width ◽  
Joint Space ◽  
Cartilage Defects ◽  
Proton Density ◽  
Bony Landmark ◽  
Mr Images ◽  
Chronic Knee Pain ◽  
Articular Surfaces ◽  
Axial View

Purpose: to validate a bony landmark on the dorsal aspect of the patella for measurement of the interbone distance in the axial radiogram of the patello-femoral joint (PFJ); to assess the reproducibility of this radiogram and the minimal joint-space (MJS) width measurements in the medial and lateral compartments of the PFJ in this view; and to relate the MJS of the PFJ to MR-detected cartilage defects in the same joint Material and Methods: Fifty-seven individuals with chronic knee pain (aged 41–58 years, mean 50 years) were examined with an axial view of the PFJ in the standing position. the MJS was measured with a mm-graded ruler. on the same day, an MR examination was performed with proton density- and T2-weighted turbo spin-echo sequences on a 1.0 T imager. We noted the cartilage defects in the PFJ in axial and sagittal MR images, and the shape of the sub-chondral cortex of the medial and lateral articular surfaces of the patella in sagittal MR images Results and Conclusion: the bony landmark was found on all articular surfaces. the axial view of the PFJ and the MJS measurements were reproducible. an MJS of < 5 mm showed high specificity for MR-detected cartilage defects. Thus an MJS of 5 mm proved to be a limit in the diagnosis of joint-space narrowing in the PFJ in middle-aged individuals with chronic knee pain

scholarly journals The evaluation of the distance between the popliteus tendon and the lateral collateral ligament footprint and the implant in Total Knee Arthroplasty using a 3-dimensional template.

2020 ◽  
Author(s):  
Akihito Takubo ◽  
Keinosuke Ryu ◽  
Takanori Iriuchishima ◽  
Masahiro Nagaoka ◽  
Yasuaki Tokuhashi ◽  
...  
Keyword(s):  
Femoral Condyle ◽  
Lateral Collateral Ligament ◽  
Lower Limbs ◽  
Lateral Femoral Condyle ◽  
Popliteus Tendon ◽  
Femoral Bone ◽  
Collateral Ligament ◽  
Bone Resection ◽  
Total Knee ◽  
Resection Area

Abstract Background The popliteus tendon (PT) or lateral collateral ligament (LCL) stabilizes the postero-lateral aspects of the knees. When surgeons perform total knee arthroplasty (TKA), PT and LCL iatrogenic injuries are a risk because the femoral attachments are relatively close to the femoral bone resection area. The purpose of this study was to evaluate the distance between the PT or LCL footprint and the TKA implant using a 3D template system and to evaluate any significant differences according to the implant model.Methods Eighteen non-paired formalin fixed cadaveric lower limbs were used (average age: 80.3). Whole length lower limbs were resected from the pelvis. All the surrounding soft tissue except the PT, knee ligaments and meniscus were removed from the limb. Careful dissection of the PT and LCL was performed, and the femoral footprints were detected. Each footprint periphery was marked with a 1.5 mm K-wire. Computed tomography (CT) scanning of the whole lower limb was then performed. The CT data was analyzed with a 3D template system. This simulation models for TKA were the Journey II BCS and the Persona PS. The area of each footprint, and the length between the most distal and posterior point of the lateral femoral condyle and the edge of each footprint were measured. Matching the implant model to the CT image of the femur, the shortest length between each footprint and the bone resection area were calculated.Results PT and LCL footprint were detected in all knees. The area of the PT and LCL footprints was 38.7±17.7mm2 and 58.0±24.6mm2, respectively. The length between the most distal and posterior point of the lateral femoral condyle and the edge of the PT footprint was 10.3±2.4mm and 14.2±2.8mm, respectively. The length between most distal and most posterior point of the lateral femoral condyle and the edge of the LCL footprint was 16.3±2.3mm and 15.5±3.3mm, respectively. Under TKA simulation, the shortest length between the PT footprint and the femoral bone resection area for the Journey II BCS and the Persona PS was 4.3±2.5mm and 3.2±2.9mm, respectively. The shortest length between the LCL footprint and the femoral bone resection area for the Journey II BCS and the Persona PS was 7.2±2.3mm and 5.6±2.1mm, respectively. The PT attachment was damaged by the bone resection of the Journey II BCS and the Persona PS TKA in 3 and 9 knees, respectively.Conclusion The PT and LCL femoral attachments existed close to the femoral bone resection area of the TKA. To prevent postero-lateral instability in TKA, careful attention is needed to avoid damage to the PT and LCL during surgical procedures.

scholarly journals The evaluation of the distance between the popliteus tendon and the lateral collateral ligament footprint and the implant in Total Knee Arthroplasty using a 3-dimensional template.

2020 ◽  
Author(s):  
Akihito Takubo ◽  
Keinosuke Ryu ◽  
Takanori Iriuchishima ◽  
Masahiro Nagaoka ◽  
Yasuaki Tokuhashi ◽  
...  
Keyword(s):  
Femoral Condyle ◽  
Lateral Collateral Ligament ◽  
Simulation Models ◽  
Ct Scanning ◽  
Lower Limbs ◽  
Lateral Femoral Condyle ◽  
Popliteus Tendon ◽  
Collateral Ligament ◽  
Bone Resection ◽  
Resection Area

Abstract Background When surgeons perform TKA, popliteus tendon (PT) and lateral collateral ligament (LCL) iatrogenic injuries are a risk because the femoral attachments are relatively close to the bone resection area. The purpose of this study was to evaluate the distance between the PT or LCL footprint and the TKA implant using a 3D template system and to evaluate any significant differences according to the implant model. Methods Eighteen non-paired formalin fixed cadaveric lower limbs were used. All the surrounding soft tissue except the PT, ligaments and meniscus were removed from the knee. Careful dissection of the PT and LCL was performed, and the femoral footprints were detected. Each footprint periphery was marked with a K-wire. CT scanning was then performed. The data was analyzed with a 3D template system. This simulation models for TKA were the Journey II BCS and the Persona PS. The area of each footprint, and the length between the most distal and posterior point of the lateral femoral condyle and the edge of each footprint were measured. Matching the implant model to the CT image, the shortest length between each footprint and the osteotomy area were calculated. Results The area of the PT and LCL footprints was 38.7±17.7mm 2 and 58.0±24.6mm 2 . The length between the most distal and posterior point of the lateral femoral condyle and the edge of the PT footprint was 10.3±2.4mm and 14.2±2.8mm. The length between these same points and the edge of the LCL footprint was 16.3±2.3mm and 15.5±3.3mm. Under TKA simulation, for the Journey II BCS and the Persona PS, the shortest length between the PT footprint and the osteotomy area was 4.3±2.5mm and 3.2±2.9mm, and the shortest length between the LCL footprint and the osteotomy area was 7.2±2.3mm and 5.6±2.1mm. The PT attachment was damaged by the bone resection of the Journey II BCS and the Persona PS TKA in 3 and 9 knee. Conclusion The PT and LCL femoral attachments existed close to the femoral bone resection area of the TKA. Careful attention is needed to avoid damage to the PT and LCL during surgical procedures.

scholarly journals Fabella Syndrome Following De-Rotation Surgery to Correct a Femoral Malunion

2018 ◽  
Vol 12 (1) ◽  
pp. 346-352 ◽  
Author(s):  
Iain Rankin ◽  
Haroon Rehman ◽  
George Patrick Ashcroft
Keyword(s):  
Knee Pain ◽  
Femoral Condyle ◽  
Femoral Shaft ◽  
Surgical Excision ◽  
Shaft Fracture ◽  
Lateral Femoral Condyle ◽  
Definitive Treatment ◽  
Review Of The Literature ◽  
Orthopaedic History ◽  
Posterolateral Knee Pain

Background:The fabella is a sesamoid bone situated within the lateral head of the gastrocnemius tendon, close to the lateral femoral condyle, and adjoined to the fabellofibular ligament. It is a normal variant, found in up to 87% of patients. Fabella Syndrome describes traditionally posterolateral knee pain, occurring due to biomechanical pressure of the fabella against the lateral femoral condyle. Given its rarity, its diagnosis is often overlooked. We present a case of Fabella Syndrome with a modified surgical excision technique and review of the literature.Methods and Results:A thirty-four-year-old man presented with posterolateral knee pain following de-rotation surgery to correct a femoral malunion, from a previous femoral shaft fracture. Due to the patient’s complex orthopaedic history, Fabella Syndrome was not initially diagnosed. Fabellectomy eliminated all symptoms of knee pain, with no limitations in knee function.Conclusion:Review of the literature identified ten publications (evidence level IV) describing Fabella Syndrome. This is the first reported case of Fabella Syndrome secondary to femoral de-rotation surgery. The authors recommend fabellectomy as a definitive treatment for Fabella Syndrome, in keeping with published literature.

Joint-space width in the weight-bearing radiogram of the tibiofemoral joint

1998 ◽  
Vol 39 (1) ◽  
pp. 32-35
Author(s):  
T. Boegård ◽  
O. Rudling ◽  
I. F. Petersson ◽  
K. Jonsson
Keyword(s):  
Knee Pain ◽  
Weight Bearing ◽  
Joint Space Width ◽  
Lateral Compartment ◽  
Joint Space ◽  
Equal Weight ◽  
Fluoroscopic Guidance ◽  
Tibiofemoral Joint ◽  
Chronic Knee Pain ◽  
Space Width

Purpose: the aim of the study was to compare the minimal joint-space (MJS) width of the tibiofemoral joint (TFJ) in weight-bearing radiograms with the patient in two different positions Material and Methods: from a study of 54 patients with chronic knee pain (aged 42–59 years, mean 52 years), we selected 21 consecutive patients for this study. in these 21 patients, both knees were examined by means of p.a. weight-bearing radiograms in semiflexion with fluoroscopic guidance. the patient stood with the weight: 1) almost entirely on the examined leg; and 2) equally distributed on both legs. the MJS was measured with a scale loupe in tenths of a millimeter in the medial and lateral compartments of the TFJ Results: with the patient standing on one leg, the MJS was 0.18 mm wider (p<0.006) in the medial compartment and 0.18 mm narrower (p<0.029) in the lateral compartment as compared to standing on both legs Conclusion: with the technique used, the assessment of the MJS width in the p.a. view of the TFJ in weight-bearing examinations should be performed with equal weight on both legs. Standing on only the examined leg might be an option in cases of suspected narrowing in the lateral compartment

scholarly journals Osteochondral Peg Fixation for Chondral Fragment of the Knee in Adolescent Patients: A Report of Two Cases

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Katsuhiro Ichikawa ◽  
Hiroyasu Ogawa ◽  
Kazu Matsumoto ◽  
Haruhiko Akiyama
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Computerized Tomography ◽  
Knee Pain ◽  
Femoral Condyle ◽  
Lateral Femoral Condyle ◽  
Chondral Defect ◽  
Resonance Imaging ◽  
Chondral Injury ◽  
Adolescent Patients

Introduction. Purely chondral injuries of the knee are relatively rare, and no consensus exists on the appropriate treatment in such cases. We describe two adolescent patients with chondral injury of the knee who were successfully treated by osteochondral peg fixation. Patients, Concerns, and Clinical Findings. In case 1, a 14-year-old boy presented with complaints of right knee pain after landing on his leg while playing basketball. Radiography and computerized tomography revealed no abnormalities. However, magnetic resonance imaging revealed a chondral defect in his lateral femoral condyle and a loose chondral fragment measuring 6.5 cm2. In case 2, a 12-year-old boy presented with complaints of left knee pain after a rotational injury while playing baseball. Similar to case 1, magnetic resonance imaging revealed a chondral defect in his lateral femoral condyle and a loose chondral fragment measuring 3.0 cm2. Primary Diagnosis, Interventions, and Outcomes. The two patients were treated by surgical fixation using osteochondral pegs, which were harvested from the femoral condyle. After a year, postoperative computerized tomography and magnetic resonance imaging showed union of the chondral fragment with the osteochondral pegs and surrounding tissue. In both cases, the Lysholm score was 100 points at the final follow-up more than 2 years after surgery. Conclusion. The findings reported herein suggest that osteochondral peg fixation is a feasible treatment option for chondral injury of the knee, with satisfactory outcomes.

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