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Table 3 Diagnostic workup and indications

From: Popliteal tendon impingement as a cause of pain following total knee arthroplasty: a systematic review

Author

Implant

Preop Alignment

Avg time from TKA to PTI diagnosis

Etiology

Diagnosis

Imaging

Injection Composition

Allardyce 1997 [19]

n/a

n/a

25 months (3–48 months)

Unclear, observed snapping

(1) Focal pain over the popliteal tendon

(2) Snapping is palpable and audible on active ROM

none

n/a

Barnes 1995 [20]

n/a

n/a

intraoperative

Posterolateral impingement against the femoral component

Snapping

none

n/a

Bonnin 2023 [24]

8 HLS-KneeTec, Tornier-Corin PS TKA, France

n/a (but TKA indication was for 7 medial and 1 lateral tibiofemoral OA)

16 months (4–30 months)

Impingement against the superior border of the posterolateral corner of the polyethylene insert

“Popliteus test” The surgeon palpated the posterolateral area of the joint line, whilst the knee was at 90° of flexion, and the patient was asked to extend her knee to full extension. The “popliteus test” was considered positive if the patient experienced excruciating pain as the knee approached full extension

3-tibial baseplate overhang visible on radio-graphs and/or CT scans;

3-PTI on ultrasound

n/a

Geannette 2014 [18]

1 revision fully constrained, 1 lateral UKR, 4 primary PS

n/a

18 months (4–44 months)

osteophyte within the popliteus sulcus of the lateral femoral condyle

(1) Focal pain over the popliteal tendon

(2) Positive impingement on dynamic ultrasonography

(3) Pain relief after diagnostic/therapeutic injection

6/6-osteophyte PTI on ultrasound

2/6-osteophyte PTI on X-Ray

2/6-osteophyte PTI on MRI

1% lidocaine and 0.25% bupivacaine mixture) and steroid (40 mg of either triamcinolone acetonide or methylpred- nisolone acetate

Kazakin 2014[26]

3 CR

Varus

intraoperative

impingement against the femoral component

Intraoperative snapping during full ROM

none

n/a

Martin 2017 [26]

1/4 Attune PS;

3/4-n/a

n/a

1.6 months

femoral component impingement

PTI test: patient lies in lateral decubitus and holds the affected knee up, flexing the knee in hip abduction from 0 to 90 degrees causes pain

none

n/a

Soejima 2016 [27]

1 Stryker Triathlon PS

Varus

2 months

impingement against the polyethylene insert at 90 degrees of flexion

Pain beyond 100 degrees of knee flexion

none

n/a

Westermann 2015 [8]

1 PS

n/a

n/a

unclear impingement, tendinopathy on arthroscopy

(1) Focal pain with clinical suspicion

(2) Failed trial of non-operative management

(3) Ultrasound-guided diagnostic injection

none

n/a

  1. TKA Total knee arthroplasty, Preop Preoperative, n/a Not available, Avg Average, OA Osteoarthritis, PS Posterior stabilized, CR Cruciate retaining, PTI Popliteal tendon impingement, UKR Unicompartmental knee replacement, ROM Range of motion, CT Computer tomography, MRI Magnetic resonance imaging