Pathologies of the popliteus tendon – A comprehensive review of the current literature

Background and Aims: In this review, we summarize the clinical and imaging features of established popliteus tendon pathologies and describe newly documented or overlooked entities to assist clinicians in recognizing these conditions to enhance diagnostic accuracy, personalize surgical strategy, and optimize patient recovery. Materials and Methods: After screening and applying the inclusion criteria, 20 studies were included in the qualitative analysis. Studies focused on human cases of traumatic, degenerative, vascular, rheumatologic, or neoplastic involvement of the popliteus tendon. Awareness of this full spectrum is important for accurate diagnosis. Sketches were created and compiled for notable pathologies to enhance clarity and visual understanding. Results: Some well-described pathologies highlighted in literature include chronic tendinopathy, acute partial or complete tendon tears (often in the setting of multiligament trauma), and avulsion fractures. Other known conditions include synovial (ganglion) cysts, calcific (hydroxyapatite) tendonitis, and autoimmune tenosynovitis (e.g., rheumatoid arthritis). Intra-articular disorders such as loose bodies and pigmented villonodular synovitis (PVNS) may track along the popliteus sheath as well. Vascular anomalies, for example, popliteal artery entrapment and rare synovial tumors (localized PVNS/giant cell tumor of tendon sheath) have been reported. Conclusion: Despite its small size, it is an important stabilizer of the knee and a potential source of posterolateral pain and instability. Its anatomical variability and broad spectrum of pathologies often lead to underdiagnosis. Improved awareness, careful imaging evaluation, and evolving arthroscopic techniques can enhance diagnostic accuracy and guide targeted treatment. Standardized surgical approaches and further research into less common popliteus-related conditions are needed to optimize clinical outcomes.