Multimedialna platforma wiedzy medycznej Internetowa Księgarnia Medyczna Kalendarium Konferencji
Folia Morphologica
MENU
Shortcuts Submit an article Author Guidelines (new) Ahead Of Print Reviewers 2023

open access

Vol 80, No 3 (2021)
Review article
Submitted: 2020-07-28
Accepted: 2020-08-11
Published online: 2020-09-02
View PDF Download PDF file
Get Citation

Current concepts on the morphology of popliteus tendon and its clinical implications

J. Zabrzyński12, G. Huri3, A. Yataganbaba3, Ł. Paczesny1, D. Szwedowski4, A. Zabrzyńska5, Ł. Łapaj6, M. Gagat2, M. Wiśniewski7, P. Pękala8910
DOI: 10.5603/FM.a2020.0106
·
Pubmed: 32896873
·
Folia Morphol 2021;80(3):505-513.
Affiliations
  1. Department of Orthopaedics, Orvit Clinic, Citomed Healthcare Centre, Torun, Poland
  2. Department of Histology and Embryology, Faculty of Medicine, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, Poland
  3. Orthopaedics and Traumatology Department, Hacettepe Universitesi, Ankara, Türkiye
  4. Orthopaedic Arthroscopic Surgery International (OASI) Bioresearch Foundation Milan, Italy
  5. Department of Radiology, Multidisciplinary Hospital, Inowroclaw, Poland
  6. Department of General Orthopaedics, Musculoskeletal Oncology and Trauma Surgery, University of Medical Sciences, Poznan, Poland
  7. Department of Normal Anatomy, Faculty of Medicine, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, Poland
  8. International Evidence-Based Anatomy Working Group, Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
  9. Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, Krakow, Poland
  10. Lesser Poland Orthopaedic and Rehabilitation Hospital, Krakow, Poland

open access

Vol 80, No 3 (2021)
REVIEW ARTICLES
Submitted: 2020-07-28
Accepted: 2020-08-11
Published online: 2020-09-02

Abstract

In this review we described the anatomy and biomechanics of popliteus muscle and its tendon. Furthermore, we combined the anatomy with clinics and discussed a wide spectrum of disorders regarding the popliteus and its musculotendinous complex. There are three main anatomical regions of the popliteus musculotendinous complex: the proximal origin, the mid-portion, the distal part on the tibia. The unique localisation and various origins of the tendon, connected with structures such as fibular head, Wrisberg, Humphrey and posterior cruciate ligament, lateral meniscus, medial collateral ligament, give an implication to diagnosis and treatment. Popliteus dysfunction is often overlooked, that is the reason why diagnosis and treatment of its injuries is mostly insufficient. Repetitive or acute direct varus forces, when the tibia is in external rotation, and knee hyperextension or flexion with forced external rotation of the tibia, are the main mechanisms of trauma. Popliteus injuries mainly affect the athletic population and lead to severe activity limitations. Chronic disorders of the popliteus tendon, less known, are often described as tendinopathy and are frequently seen in runners. Their symptoms can mimic the lateral meniscal tears. On the other hand, high-energy traumatic injuries of the popliteus tendon often accompany complex, multi ligamentous injuries seen in competitive sports. We also presented the implication of popliteus tendon in knee arthroplasty, due to its particular exposition to iatrogenic trauma during surgery. The issues such as proper tibial component location and well-designed cut systems are crucial to avoid the popliteus impingement and preserve its structure.

Abstract

In this review we described the anatomy and biomechanics of popliteus muscle and its tendon. Furthermore, we combined the anatomy with clinics and discussed a wide spectrum of disorders regarding the popliteus and its musculotendinous complex. There are three main anatomical regions of the popliteus musculotendinous complex: the proximal origin, the mid-portion, the distal part on the tibia. The unique localisation and various origins of the tendon, connected with structures such as fibular head, Wrisberg, Humphrey and posterior cruciate ligament, lateral meniscus, medial collateral ligament, give an implication to diagnosis and treatment. Popliteus dysfunction is often overlooked, that is the reason why diagnosis and treatment of its injuries is mostly insufficient. Repetitive or acute direct varus forces, when the tibia is in external rotation, and knee hyperextension or flexion with forced external rotation of the tibia, are the main mechanisms of trauma. Popliteus injuries mainly affect the athletic population and lead to severe activity limitations. Chronic disorders of the popliteus tendon, less known, are often described as tendinopathy and are frequently seen in runners. Their symptoms can mimic the lateral meniscal tears. On the other hand, high-energy traumatic injuries of the popliteus tendon often accompany complex, multi ligamentous injuries seen in competitive sports. We also presented the implication of popliteus tendon in knee arthroplasty, due to its particular exposition to iatrogenic trauma during surgery. The issues such as proper tibial component location and well-designed cut systems are crucial to avoid the popliteus impingement and preserve its structure.

Full Text:

View PDF Download PDF file
Get Citation

Keywords

popliteus muscle, tendinopathy, posterolateral corner, popliteus reconstruction, popliteus tendon

About this article
Title

Current concepts on the morphology of popliteus tendon and its clinical implications

Journal

Folia Morphologica

Issue

Vol 80, No 3 (2021)

Article type

Review article

Pages

505-513

Published online

2020-09-02

Page views

9182

Article views/downloads

4257

DOI

10.5603/FM.a2020.0106

Pubmed

32896873

Bibliographic record

Folia Morphol 2021;80(3):505-513.

Keywords

popliteus muscle
tendinopathy
posterolateral corner
popliteus reconstruction
popliteus tendon

Authors

J. Zabrzyński
G. Huri
A. Yataganbaba
Ł. Paczesny
D. Szwedowski
A. Zabrzyńska
Ł. Łapaj
M. Gagat
M. Wiśniewski
P. Pękala

References (50)
  1. Ahn JH, Wang JHo, Lee SY, et al. Arthroscopic-assisted anatomical reconstruction of the posterolateral corner of the knee joint. Knee. 2019; 26(5): 1136–1142.
    CrossRefPubMed
  2. Aman ZS, DePhillipo NN, Storaci HW, et al. Quantitative and qualitative assessment of posterolateral meniscal anatomy: defining the popliteal hiatus, popliteomeniscal fascicles, and the lateral meniscotibial ligament. Am J Sports Med. 2019; 47(8): 1797–1803.
    CrossRefPubMed
  3. Bartonícek J. Rare bilateral variation of the popliteus muscle: anatomical case report and review of the literature. bartonic@fnkv.cz. Surg Radiol Anat. 2005; 27(4): 347–350.
    CrossRefPubMed
  4. Blake SM. Popliteus tendon tenosynovitis.* Commentary. Br J Sports Med. 2005; 39(12): e42.
    CrossRefPubMed
  5. Bonnin MP, de Kok A, Verstraete M, et al. Popliteus impingement after TKA may occur with well-sized prostheses. Knee Surg Sports Traumatol Arthrosc. 2017; 25(6): 1720–1730.
    CrossRefPubMed
  6. Brown TR, Quinn SF, Wensel JP, et al. Diagnosis of popliteus injuries with MR imaging. Skeletal Radiol. 1995; 24(7): 511–514.
    CrossRefPubMed
  7. Burstein D, Fischer D. Isolated rupture of the popliteus tendon in a professional athlete. Arthroscopy. 1990; 6(3): 238–241.
    CrossRef
  8. Chahla J, Moatshe G, Dean CS, et al. Posterolateral corner of the knee: current concepts. Arch Bone Jt Surg. 2016; 4(2): 97–103.
    PubMed
  9. Chahla J, Murray IR, Robinson J, et al. Posterolateral corner of the knee: an expert consensus statement on diagnosis, classification, treatment, and rehabilitation. Knee Surg Sports Traumatol Arthrosc. 2019; 27(8): 2520–2529.
    CrossRefPubMed
  10. Cottino U, Bruzzone M, Rosso F, et al. The role of the popliteus tendon in total knee arthroplasty: a cadaveric study: SIGASCOT Best Paper Award Finalist 2014. Joints. 2015; 3(1): 15–19.
    PubMed
  11. Crum JA, LaPrade RF, Wentorf FA. The anatomy of the posterolateral aspect of the rabbit knee. J Orthop Res. 2003; 21(4): 723–729.
    CrossRefPubMed
  12. Doucet C, Gotra A, Reddy SM, et al. Acute calcific tendinopathy of the popliteus tendon: a rare case diagnosed using a multimodality imaging approach and treated conservatively. Skeletal Radiol. 2017; 46(7): 1003–1006.
    CrossRefPubMed
  13. Fanelli GC, Larson RV. Practical management of posterolateral instability of the knee. Arthroscopy. 2002; 18(2 Suppl 1): 1–8.
    CrossRefPubMed
  14. Geeslin AG, LaPrade RF. Location of bone bruises and other osseous injuries associated with acute grade III isolated and combined posterolateral knee injuries. Am J Sports Med. 2010; 38(12): 2502–2508.
    CrossRefPubMed
  15. Geeslin AG, Moulton SG, LaPrade RF. A Systematic Review of the Outcomes of Posterolateral Corner Knee Injuries, Part 1: Surgical Treatment of Acute Injuries. Am J Sports Med. 2016; 44(5): 1336–1342.
    CrossRefPubMed
  16. Guha AR, Gorgees KA, Walker DI. Popliteus tendon rupture: a case report and review of the literature. Br J Sports Med. 2003; 37(4): 358–360.
    CrossRefPubMed
  17. Huang GS, Yu JS, Munshi M, et al. Avulsion fracture of the head of the fibula (the "arcuate" sign): MR imaging findings predictive of injuries to the posterolateral ligaments and posterior cruciate ligament. AJR Am J Roentgenol. 2003; 180(2): 381–387.
    CrossRefPubMed
  18. Huri G, Biçer OS. Unusual cause of knee locking. Case Rep Orthop. 2013; 2013: 837140.
    CrossRefPubMed
  19. Jadhav SP, More SR, Riascos RF, et al. Comprehensive review of the anatomy, function, and imaging of the popliteus and associated pathologic conditions. Radiographics. 2014; 34(2): 496–513.
    CrossRefPubMed
  20. Jakobsen BW, Lund B, Christiansen SE, et al. Anatomic reconstruction of the posterolateral corner of the knee: a case series with isolated reconstructions in 27 patients. Arthroscopy. 2010; 26(7): 918–925.
    CrossRefPubMed
  21. Kannus P. Nonoperative treatment of grade II and III sprains of the lateral ligament compartment of the knee. Am J Sports Med. 1989; 17(1): 83–88.
    CrossRefPubMed
  22. 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.
    CrossRefPubMed
  23. Krudwig WK, Witzel U, Ullrich K. Posterolateral aspect and stability of the knee joint. II. Posterolateral instability and effect of isolated and combined posterolateral reconstruction on knee stability: a biomechanical study. Knee Surg Sports Traumatol Arthrosc. 2002; 10(2): 91–95.
    CrossRefPubMed
  24. LaPrade RF, Gilbert TJ, Bollom TS, et al. The magnetic resonance imaging appearance of individual structures of the posterolateral knee. A prospective study of normal knees and knees with surgically verified grade III injuries. Am J Sports Med. 2000; 28(2): 191–199.
    CrossRefPubMed
  25. LaPrade RF, Heikes C, Bakker AJ, et al. The reproducibility and repeatability of varus stress radiographs in the assessment of isolated fibular collateral ligament and grade-III posterolateral knee injuries. An in vitro biomechanical study. J Bone Joint Surg Am. 2008; 90(10): 2069–2076.
    CrossRefPubMed
  26. LaPrade R, Ly T, Wentorf F, et al. The Posterolateral Attachments of the Knee. Am J Sports Med. 2017; 31(6): 854–860.
    CrossRef
  27. LaPrade RF, Wozniczka JK, Stellmaker MP, et al. 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): 543–549.
    CrossRefPubMed
  28. Levy BA, Dajani KA, Morgan JA, et al. Repair versus reconstruction of the fibular collateral ligament and posterolateral corner in the multiligament-injured knee. Am J Sports Med. 2010; 38(4): 804–809.
    CrossRefPubMed
  29. Liu JN, Rebolledo BJ, Warren RF, et al. Surgical management of isolated popliteus tendon injuries in paediatric patients. Knee Surg Sports Traumatol Arthrosc. 2016; 24(3): 788–791.
    CrossRefPubMed
  30. De Maeseneer M, Shahabpour M, Vanderdood K, et al. Posterolateral supporting structures of the knee: findings on anatomic dissection, anatomic slices and MR images. Eur Radiol. 2001; 11(11): 2170–2177.
    CrossRefPubMed
  31. Mirkopulos N, Myer TJ. Isolated avulsion of the popliteus tendon. A case report. Am J Sports Med. 1991; 19(4): 417–419.
    CrossRefPubMed
  32. Nakhostine M, Perko M, Cross M. Isolated avulsion of the popliteus tendon. J Bone Joint Surg Br. 1995; 77(2): 242–244.
    PubMed
  33. Nyland J, Lachman N, Kocabey Y, et al. Anatomy, function, and rehabilitation of the popliteus musculotendinous complex. J Orthop Sports Phys Ther. 2005; 35(3): 165–179.
    CrossRefPubMed
  34. Paraskevas G, Papaziogas B, Kitsoulis P. A study on the morphology of the popliteus muscle and arcuate popliteal ligament. Folia Morphol. 2006; 65(4): 381–384.
    PubMed
  35. Peduto AJ, Nguyen A, Trudell DJ, et al. Popliteomeniscal fascicles: anatomic considerations using MR arthrography in cadavers. Am J Roentgenol. 2008; 190(2): 442–448.
    CrossRefPubMed
  36. Petsche TS, Selesnick FH. Popliteus tendinitis: tips for diagnosis and management. Phys Sportsmed. 2002; 30(8): 27–31.
    CrossRefPubMed
  37. Porrino J, Sharp JW, Ashimolowo T, et al. An update and comprehensive review of the posterolateral corner of the knee. Radiol Clin North Am. 2018; 56(6): 935–951.
    CrossRefPubMed
  38. Quinlan JF, Webb S, McDonald K, et al. Isolated popliteus rupture at the musculo-tendinous junction. J Knee Surg. 2011; 24(2): 137–140.
    CrossRefPubMed
  39. Rosas HG. Unraveling the posterolateral corner of the knee. Radiographics. 2016; 36(6): 1776–1791.
    CrossRefPubMed
  40. Shelbourne KD, Haro MS, Gray T. Knee dislocation with lateral side injury: results of an en masse surgical repair technique of the lateral side. Am J Sports Med. 2007; 35(7): 1105–1116.
    CrossRefPubMed
  41. Shon OJ, Park JW, Kim BJ. Current concepts of posterolateral corner injuries of the knee. Knee Surg Relat Res. 2017; 29(4): 256–268.
    CrossRefPubMed
  42. Simonnet ML, Rooze M, Feipel V. The proximal attachments of the popliteus muscle: a quantitative study and clinical significance. Surg Radiol Anat. 2003; 25(1): 58–63.
    CrossRefPubMed
  43. Song Y, Xiong Y, Chen W, et al. Sectional anatomy and three-dimensional visualization of the posterolateral complex of the knee joint based on undeformed high-resolution sectional anatomical images. Anat Rec (Hoboken). 2018; 301(10): 1764–1773.
    CrossRefPubMed
  44. Stannard JP, Brown SL, Farris RC, et al. The posterolateral corner of the knee: repair versus reconstruction. Am J Sports Med. 2005; 33(6): 881–888.
    CrossRefPubMed
  45. Takahashi A, Sugita T, Aizawa T, et al. Potential risk of excising the femoral insertion of the popliteus tendon during primary total knee arthroplasty: a biometric study. J Orthop Sci. 2015; 20(6): 1030–1035.
    CrossRefPubMed
  46. Takeda S, Tajima G, Fujino K, et al. Morphology of the femoral insertion of the lateral collateral ligament and popliteus tendon. Knee Surg Sports Traumatol Arthrosc. 2015; 23(10): 3049–3054.
    CrossRefPubMed
  47. Takubo A, Ryu K, Iriuchishima T, et al. 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. BMC Musculoskelet Disord. 2020; 21(1): 322.
    CrossRefPubMed
  48. Taylor G, Bonney V. On the homology and morphology of the popliteus muscle: a contribution to comparative myology. J Anat Physiol. 1905; 40(Pt 1): 34–50.
    PubMed
  49. Tria AJ, Johnson CD, Zawadsky JP. The popliteus tendon. J Bone Joint Surg Am. 1989; 71(5): 714–716.
    PubMed
  50. Yang JH, Lim HC, Bae JiH, et al. 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): 1669–1674.
    CrossRefPubMed

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By VM Media Group sp. z o.o., Grupa Via Medica, Świętokrzyska 73, 80–180 Gdańsk, Poland

tel.: +48 58 320 94 94, faks: +48 58 320 94 60, e-mail: viamedica@viamedica.pl