All-arthroscopic anatomic repair of an avulsed popliteus tendon in a multiple ligament-injured knee.

Abstract

Multiple ligament-injured knees are a heterogeneous group of knee injuries that lack a clear consensus on optimal treatment. Current areas of controversy include optimal timing of surgery, ligamentous repair vs reconstruction, and combined vs staged procedures. In addition, multiple open, arthroscopic, and arthroscopic-assisted techniques exist for repair and reconstruction of the injured stabilizers of the knee.Many open posterolateral corner reconstruction techniques have been described, and this article represents the first description of an arthroscopic technique for repair of an avulsed popliteus tendon. This was performed with a standard anterolateral portal in addition to anterior and posterior superolateral portals. Nonabsorbable sutures were passed through the avulsed popliteus tendon in an outside-in technique using a suture shuttle. The nonabsorbable sutures were threaded though a tibial Beath pin, which was then passed through the prepared popliteus footprint and brought out medially. The final position of the popliteus was confirmed arthroscopically, and the sutures were tied medially over a screw post with a washer.Arthroscopic popliteus repair has many possible advantages. Because the popliteus tendon insertion is intracapsular, open repair necessitates a capsulotomy, with the potential for complications such as postoperative wound drainage, intra-articular sinus formation, infection, and stiffness. Arthroscopic repair may avoid these complications. The current case was performed in conjunction with an open but extracapsular posterolateral corner repair. Further experience with this technique is required to determine its safety and efficacy.