Arthroscopic Tenotomy Results in Complete Resolution of Snapping Popliteus Tendon Syndrome After Total Knee Arthroplasty-A Case Report

Introduction: Snapping Popliteus Tendon Syndrome (STPS) is a rare complication following Total Knee Arthroplasty (TKA) characterized by painful, palpable and audible snapping in the lateral knee.Our case demonstrates complete resolution of SPTS with exclusively diagnostic and therapeutic popliteus tendon sheath injection followed by arthroscopic popliteus tendon tenotomy. Case Presentation:We present the case of a 60-year-old female 5 weeks status post TKA who presents with SPTS despite following postoperative rehabilitation protocol.Palpable snapping was elicited on the posterolateral aspect of the knee upon passive ROM examination.The patient had complete relief following ultrasound guided tendon sheath injection for 3 weeks, followed by arthroscopic tenotomy which demonstrated clear trapping of the popliteus tendon in the arthroplasty components. Results:The patient reported 85% improvement in all symptoms by 2 weeks, return to significant physical activity by 8 weeks, and continued complete resolution of snapping sensation and pain at final follow up, 10 months postoperatively.Conclusions: Isolated arthroscopic popliteus tenotomy offers a minimally invasive, anatomy-preserving treatment for SPTS post-TKA and does not lead to rotatory instability of the components.The application of dynamic ultrasound with guided injection is a strong diagnostic tool for dynamic tendon pathology.