If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. A symptomatic cyamella in the popliteus tendon causing. Tearing and inflammation of the popliteus tendon and occurs most commonly in runners that produce oblique lateral rotary stresses to the knee or those who run down hill frequently dutton. Popliteus tendinopathy has a similar mri appearance to tendinopathy in other locations albeit a rare site.
A case is here reported of a semiprofessional athlete with a ruptured popliteus tendon without significant instability of the knee. They support that joint effusion of knee falls down popliteus muscle through the popliteal hiatus. Snapping knee is an uncommon problem which can be difficult to diagnose. Popliteal muscle and tendon injuries are thought to be unusual. Its deepest muscle of the knee joint which forms the floor of the popliteus fossa. Anatomy of the popliteus muscle everything you need to. Diagnosing and treating popliteal tendinopathy after total knee arthroplasty.
The popliteus is a small muscle located at the back of the knee joint. Surgical approach to pigmented villonodular synovitis and. Isolated rupture of the popliteus musculotendinous unit is an uncommon injury. The popliteus muscle originates on the posterior tibia just proximal to the soleal line and proceeds lateral and proximal to insert on the lateral femoral condyle see fig. Popliteus tendon tenosynovitis is a relatively uncommon condition which most often occurs in athletes or is associated with other knee ligament injuries after trauma. Mri allows to eliminate a meniscal lesion and popliteus tendon, rather than arthroscopy. The popliteus muscle is a fairly small muscle located behind the knee. Popliteus damage leading to significant incompetence of this structure, is generally in the form of an avulsion a tearing off in the region where the tendon attaches to the femur. The diagnosis was made by magnetic resonance imaging and confirmed by. Popliteus is a triangular shaped muscle that is found deep in the popliteal fossa at the back of the knee, just below the joint. The popliteus tendon goes from the back of your thighbone across the back of your knee. Arthroscopic management of popliteal tendon dysfunction in. Partial isolated rupture of the popliteus tendon in a.
It is highly unusual for this condition to present in a nonathlete without a history of knee trauma and indeed has not been previously described in this type of patient. Of those treated without surgery, two had spontaneous resolution of the popping, in one the popping persisted, although not symptomatic enough to require surgery, and one had surgery later. The isolated rupture of the popliteus tendon is a very rare injury and it has been rarely reported in the literature as a cause of knee hemarthrosis and functional disabilities. Simeon asher treating trigger points in popliteus the deep location of popliteus and its relatively small size, mean that it is often overlooked. Different types of popliteus tendon pt attachment in the right knees. Magnetic resonance mr imaging is the imaging modality of choice for evaluation of acute traumatic musculotendinous injuries of the knee.
Popliteus tendon tenosynovitis british journal of sports. Popliteus tendinopathy is a little different when compared to popliteus strains and tears. The popliteus is a small muscle which is located at the back of your knee. For this reason rupture of the popliteus muscle is usually associated with acute or chronic posterolateral instability of the knee. If you take the time to rest now, you will notice much faster healing, though rest alone will not accelerate recovery. We orthopaedic surgeons are not familiar with the popliteus bursa. In open chain movements when the involved limb is not in contact with the ground, the popliteus muscle medially rotates the tibia on the femur. This report describes the magnetic resonance mr appearances of popliteus muscle and tendon injuries. Basset dl 1962 a stereoscopic atlas of human anatomy. The syndrome of the snapping popliteus tendon is a rare cause of lateral knee pain and may be difficult to diagnose, leading to patients undergoing inappropriate therapy or surgical intervention. The popliteus muscle is responsible for internal rotation of the shin bone as well as for unlocking the knee joint when bending the knee.
Pain and snapping along the outside border of the knee can be caused by a variety of problems. Partial tendon release for treatment of a symptomatic. Popliteus poplihtus tenosynovitis tenosinovitis is a tear in the popliteus tendon. Popliteal tendinopathy tendinitis refers to an overuse injury of the popliteal tendon.
The popliteus muscle provides the knee with an added degree of mobility. Popliteus tendon resection during total knee arthroplasty. The popliteus muscle and tendon stabilize the posterolateral corner of the knee and prevent anterior translation, especially during downhill running muche. Popliteus tendonitis differential diagnosis of the knee. It also has an origin stemming from the posterior horn of the lateral meniscus. The first step to healing your popliteus muscle is avoiding the activity that caused the injury. Download scientific diagram popliteus hiatus ph exposed, popliteus tendon pt divided and reflected with its popliteomeniscal ligament superior and. It runs from the lateral side outside of the femur to the medial side of the tibia, lying deep b. With the muscle, the knee is able to rotate within the body by prompting the femur to. In this report, we describe the arthroscopic findings of the snapping popliteus tendon. Actual tears of the substance of the popliteus are less common, but do happen, and bleeding may occur into the joint. Snapping popliteus tendon orthopedic physical therapy.
The diagnosis was made by magnetic resonance imaging and confirmed by arthroscopy. The popliteus muscle is a small muscle located at the knee joint it originates from the femur and the posterior horn of the lateral meniscus, while it inserts above the origin of the soleus muscle. The study group was taken from 2412 consecutive knee mris. Simply select your manager software from the list below and click on download. An injury or strain to the muscle or tendon can cause pain at the back of the knee. Prevalence and potential etiology article in the journal of bone and joint surgery 90 suppl 4. Arthroscopic diagnosis of the snapping popliteus tendon.
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. Posterolateral corner injuries include tears of the popliteus tendon, lateral collateral ligament, lateral capsular ligament and arcuate ligament complex. The popliteus tendon and its fascicles at the popliteal hiatus. Rarely an ossicle called a cyamella is seen here, located. The popliteus muscle in the leg is used for unlocking the knees when walking, by medially rotating the tibia during the closed chain portion of the gait cycle one with the foot in contact with the ground.
The popliteus tendon originates on the lateral surface of the lateral femoral condyle in front of and below the lateral collateral ligament origin and also from the fibular head. Unexplainable knee pain may follow knee replacement surgery. Watch the full version of this video to learn all about the functions of the popliteus muscle in 3d. The popliteus bursa extends approximately 1 cm distal to the joint line and has 4 borders. The groove for the popliteus tendon is a normal variant and should not be mistaken for a fracture. Groove for the popliteus tendon radiology reference article. Isolated popliteus muscle rupture with neurovascular. Popliteus tenosynovitis aftercare instructions what.
Popliteus arises from the outer surface of the lateral femoral condyle, from within the joint capsule, below the lateral epicondyle and the superior attachment of the lateral collateral ligament. Popliteus tendinopathy occurs when there has been an overuse of the popliteus tendon over a. Release the back of the knee and activate the vastus medialis to bring flexibility and stability to the knee. Snapping popliteus tendon in a 21yearold female j orthop sports phys ther 2008.
A tendon is a thick cord of tough tissue that connects your muscles to your bones. Download scientific diagram different types of popliteus tendon pt attachment in the right knees. The tendon can snap over or impinge on lateral osteophytes or prominent femoral components and produce mechanical symptoms and pain. In this case, we report a 24yearold male with snapping knee caused by symptomatic cyamella in the popliteus tendon. The study included 24 patients where the diagnoses of popliteal injuries were prospectively made based on mr appearances.
It is the only muscle in the posterior back compartment of the lower leg that acts just on the knee and not on the ankle. The popliteus muscle is a small muscle located at the knee joint. The popliteus tendon goes from the bottom back of the thighbone across the back of the knee to the top front of the shinbone. Popliteus tendonitis, or tenosynovitis, is a tear in the popliteus tendon. Stretch the very small and difficult to access popliteus. The aim of this study was to verify the occurrence and width of popliteus attachments on the articular and periarticular structures of the knee joint. Cyamella,the sesamoid bones of the popliteus muscle, are rare in humans.
Multiple accessory, supernumerary, and anomalous muscles have been described in the medical literature. The popliteus muscle is a triangular muscle with a narrow tendinous origin and broad insertion. It could be iliotibial friction syndrome, meniscus tear, degenerative joint disease, or even a loose fragment in the joint. Partial tendon release for treatment of a symptomatic snapping biceps femoris tendon. Three discrete categories of acute injuries to the musculotendinous unit can be defined. But knowledge of these muscles is important because they can mimic a soft tissue tumor, can compress the popliteal artery andor popliteal vein, and rarely may cause neural compression. Postoperatively, the patient had immediate relief of. Popliteus tendon release in the varus or neutral knee.
Exercises can also strengthen the muscles around your knee so the popliteus muscle doesnt bear all of your weight and the burden of walking or running movements. A large cyamella was identified upon surgery and was removed. The stout tendon passes backwards, downwards and medially. You need the same healing tools that allow professional athletes to get back into the game so soon. Clear explanations of natural written and spoken english. Diagnosis of popliteus injuries with mr imaging springerlink. Trigger point therapy treating popliteus niel asher.
Ultrasoundguided injections may confirm the diagnosis and provide. The popliteal tendon should be evaluated as a possible cause of lateral knee pain and dysfunction after knee arthroplasty. A tendon is a cord of tough tissue that connects muscles to bones. Lovejoy jf, harden tp 1971 popliteus muscle in man. Accessory muscles of the knee are typically asymptomatic. Popliteus tendinitis joint replacement patient forum. One comment on the popliteus, the tiny muscle of knee pain. The poplitues muscle is a small, short muscle located deep on the back of the knee. Diagnosing and treating popliteal tendinopathy after total. The triangular area above the line is occupied by the popliteus muscle, while the area below is marked by rough lines linese musculares to which the deep flexor muscle of the digit is attached.
It tends to cause posterolateral knee pain on exercise e. The popliteus tendon goes from the bottom back of the thighbone across the. It is defined as the expansion in the synovial membrane of the posterolateral part of the knee that lies between the lateral meniscus and the tendon of the popliteus muscle. Last rj 1950 the popliteus muscle and lateral meniscus. The popliteus tendon proceeds proximally through a hiatus in the coronary ligament of the lateral meniscus, then deep to the fcl to ultimately insert anterior and distal to the insertion of the fcl see fig. Deposition of calcium salts in the popliteus tendon.
At mr imaging, the popliteus tendon may show increased intrasubstance signal on t2weighted images and fluid surrounding the tendon fig 23. Listen to the audio pronunciation in the cambridge english dictionary. By strengthening other muscles in your lower limbs, including your calves, hips and pelvic muscles, popliteus muscle exercises may. Popliteus hiatus ph exposed, popliteus tendon pt divided and. It is a key stabilizer muscle of the knee, and plays an important role in maintaining proper mechanics at the knee with weightbearing activities such as walking, running, and climbing stairs. If you want to heal as quickly as possible, you need something more aggressive. Fluid surrounding the popliteus tendon in the absence of joint effusion should raise suspicion of tenosynovitis. The popliteus muscle in the leg is used for unlocking the knees when walking, by laterally rotating the femur on the tibia during the closed chain portion of the gait cycle one with the foot in contact with the ground.
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