Novel Technique may Address Retained Loose Bodies in Popliteal Cyst During TKA without separate incision: Study

Written by Dr Supreeth D R Published On 2025-05-28T20:45:03+05:30 | Updated On 29 May 2025 12:04 PM IST

Novel Technique may Address Retained Loose Bodies in Popliteal Cyst During TKA without separate incision: Study

In planning total knee arthroplasty (TKA), preoperative radiographs may show calcific bodies in the posterior soft tissues of the knee. Zachary J. Sirois et al describe a technique in which they can be removed without making a separate skin incision during TKA after femoral and tibial bone resection. This technique involves probing the posteromedial capsule with a clamp to identify the opening to a popliteal cyst. Once identified, the opening is tensioned and incised to allow removal of the loose bodies. If retained, these loose bodies can be a source of patient dissatisfaction, particularly since they are sometimes palpable to the patient. This is the first technique to describe removal of such loose bodies during routine TKA without an additional incision.

Surgical technique

Routine exposure for TKA is performed. The femoral and tibial bone resections are made. The knee is placed in 90deg of flexion and a lamina spreader is placed in the lateral compartment to distract the flexion gap. One visualizes the posteromedial capsule and probes with a Kelly clamp to identify the opening to the popliteal cyst. Once identified, the opening is stretched in a medial lateral direction with the Kelly clamp. This tensions the capsule so the opening can be enlarged by incising proximally and distally with electrocautery or a #15 blade. Once the opening has been enlarged, the Kelly clamp can reach into the cyst and palpate and grasp and remove loose bodies. Sometimes palpating the posterior aspect of the knee can help direct a loose body to the clamp. After removal of the loose bodies, the vertical incision in the posterior capsule does not require closure. No adjustments are made to the normal postoperative protocol.

The article has been published in ‘Arthroplasty today.’

The authors commented – “Retained loose bodies in a popliteal cyst may be a source of postoperative pain or dissatisfaction following TKA. We present a novel technique to remove loose bodies within the popliteal cyst during routine TKA without a separate incision to improve overall patient satisfaction.”

MBBS, Dip. Ortho, DNB ortho, MNAMS

Dr Supreeth D R (MBBS, Dip. Ortho, DNB ortho, MNAMS) is a practicing orthopedician with interest in medical research and publishing articles. He completed MBBS from mysore medical college, dip ortho from Trivandrum medical college and sec. DNB from Manipal Hospital, Bengaluru. He has expirence of 7years in the field of orthopedics. He has presented scientific papers & posters in various state, national and international conferences. His interest in writing articles lead the way to join medical dialogues. He can be contacted at editorial@medicaldialogues.in.