Minimally Invasive Arthroscopic Approach to Popliteal Tendon Impingement in a Degenerative Knee: A Case Report.

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.