Iatrogenic Popliteus Tendon Injury During Total Knee Arthroplasty

Background. The popliteus tendon (PT) plays a role in knee unlocking and posterolateral stability, yet the clinical impact of its iatrogenic injury during total knee replacement (TKR) remains poorly defined. This study aimed to evaluate the outcomes of patients with documented intraoperative PT injury during posterior-stabilised TKR. Methods. A retrospective review was conducted on 111 varus knees undergoing posterior-stabilised TKR. Among these, seven cases (6.3%) of intraoperative PT injury were identified. The cohort had a mean age of 71 years and an average preoperative varus deformity of 14°. PT repair was performed in two of the seven injured cases. Results. At a mean follow-up of three years, all knees were assessed as stable. The average postoperative varus alignment was 2°. Functional outcomes were favorable, with a mean International Knee Society (IKS) knee score of 89 and an IKS functional score of 74.5. All patients expressed satisfaction with their results. Conclusion. Iatrogenic PT injury did not appear to adversely affect postoperative stability or functional outcomes in posterior-stabilised TKR. However, larger prospective studies are required to fully determine the long-term clinical significance of this finding.