Nagasaki Kei, Ishikawa Hiroki, Ohno Takuya, Seino Taketoshi, Mitsuhashi Manabu, Kudo Yoshifumi
Department of Orthopedic Surgery, Showa University School of Medicine, Tokyo, JPN.
Department of Orthopedic Surgery, Nippon Koukan Hospital, Kawasaki, JPN.
Cureus. 2025 May 4;17(5):e83450. doi: 10.7759/cureus.83450. eCollection 2025 May.
Posterolateral knee pain can occur due to various causes, including meniscal tears, intra-articular loose bodies, ligament injuries, and tendinitis. Popliteal tendon impingement (PTI) due to osteophytes is a less common but significant cause of posterolateral knee pain, and treatment options for PTI are not well established. This report aimed to explore a minimally invasive approach to treating PTI in a degenerative knee using arthroscopic osteophyte resection. A 62-year-old man presented to our hospital with posterolateral knee pain and restricted range of motion (ROM) in the right knee. Imaging revealed significant osteophyte formation causing PTI. Conservative treatment failed. Thus, arthroscopic osteophyte resection was performed. Postoperatively, the patient significantly improved. The ROM improved from 90° of flexion with an extension lag of 5° preoperatively to 130° of flexion and full extension at three months postoperatively. The Knee Injury and Osteoarthritis Outcome Score (KOOS) improved from 52% to 74%, with complete resolution of pain. Comprehensive management, including precise diagnosis, judicious patient selection, and targeted arthroscopic intervention, is critical regardless of whether PTI is encountered in degenerative knees or following total knee arthroplasty (TKA). Arthroscopic osteophyte resection is a promising option for alleviating pain and improving function while preserving stability. Further studies are needed to strengthen the evidence base.
膝关节后外侧疼痛可由多种原因引起，包括半月板撕裂、关节内游离体、韧带损伤和肌腱炎。骨赘导致的腘肌腱撞击（PTI）是膝关节后外侧疼痛的一种较不常见但重要的原因，且PTI的治疗方案尚未明确。本报告旨在探讨一种使用关节镜下骨赘切除术治疗退行性膝关节PTI的微创方法。一名62岁男性因右膝关节后外侧疼痛和活动范围（ROM）受限就诊于我院。影像学检查显示有明显的骨赘形成导致PTI。保守治疗失败。因此，进行了关节镜下骨赘切除术。术后，患者明显好转。活动范围从术前屈曲90°伴5°伸直滞后改善为术后3个月时屈曲130°且完全伸直。膝关节损伤和骨关节炎疗效评分（KOOS）从52%提高到74%，疼痛完全缓解。无论PTI是在退行性膝关节中还是在全膝关节置换术（TKA）后出现，综合管理，包括精确诊断、明智的患者选择和有针对性的关节镜干预都至关重要。关节镜下骨赘切除术是一种在保留稳定性的同时减轻疼痛和改善功能的有前景的选择。需要进一步研究以加强证据基础。
