The popliteus tendon is a thin, rope-like intraarticular tendon arising from the popliteal sulcus on the posterolateral surface of the lateral femoral condyle, passing inferior and medial through the popliteal hiatus of the lateral meniscus to become the popliteus muscle belly. It is the only intraarticular structure on the lateral side of the knee (analogous to the PCL and ACL on the posterior side). It passes deep to the lateral collateral ligament and the popliteofibular ligament and receives attachments from the posterior horn of the lateral meniscus.
The popliteus tendon is a key component of the posterolateral corner (PLC) of the knee and resists external tibial rotation and posterolateral drawer. Popliteus tendinopathy produces isolated lateral knee pain at the popliteal sulcus, reproduced by resisted internal rotation of the tibia with the knee flexed at 90 degrees (Garrick test). The tendon is a key landmark in lateral knee arthroscopy: the popliteal hiatus in the posterior horn of the lateral meniscus marks the probe entry point for the posterolateral compartment. PLC injury involves the popliteus-popliteofibular ligament complex.
Combined PCL and posterolateral corner injury involves the popliteus tendon as part of the PLC complex, producing posterolateral drawer and external rotation instability; PLC reconstruction includes restoration of the popliteus-fibular complex using an allograft or autograft from the fibular head to the popliteal sulcus, combined with PCL reconstruction.
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