TY - JOUR
T1 - Potential risk of excising the femoral insertion of the popliteus tendon during primary total knee arthroplasty
T2 - a biometric study
AU - Takahashi, Atsushi
AU - Sugita, Takehiko
AU - Aizawa, Toshimi
AU - Chiba, Daisuke
AU - Kamimura, Masayuki
AU - Aki, Takashi
AU - Itoi, Eiji
PY - 2015/11/1
Y1 - 2015/11/1
N2 - 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.
AB - 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.
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U2 - 10.1007/s00776-015-0773-x
DO - 10.1007/s00776-015-0773-x
M3 - Article
C2 - 26362655
AN - SCOPUS:84947612252
VL - 20
SP - 1030
EP - 1035
JO - Journal of Orthopaedic Science
JF - Journal of Orthopaedic Science
SN - 0949-2658
IS - 6
ER -