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Review Question - QID 6056

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QID 6056 (Type "6056" in App Search)
Figures 57a through 57c show the radiographs of a patient who has pain, discomfort, and a popping sensation localized to the posterior aspect of the knee after undergoing primary left total knee arthroplasty 6 months ago. Examination reveals that the patient is able to ambulate without a limp. There is no significant swelling, erythema, or effusion. Range of motion is 0 degrees to 115 degrees, and a palpable crepitation or snapping is detected at the posterior lateral joint line. What is the most likely diagnosis?
  • A
  • B
  • C

Popliteal snapping syndrome

77%

512/664

Patellar clunk syndrome

9%

63/664

Subluxation secondary to a tight posterior cruciate ligament

6%

37/664

Soft-tissue irritation secondary to retained polymethylmethacrylate

5%

31/664

Patellar subluxation secondary to a tight lateral retinaculum

3%

17/664

  • A
  • B
  • C

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Popliteal snapping syndrome represents the most likely diagnosis. Barnes and Scott noted that the popliteus tendon can be a potential source of internal derangement after total knee arthroplasty. They noted that it can be subluxated anteriorly and posteriorly over a retained lateral femoral condyle osteophyte. Allardyce and associates described the condition as a popliteus condition, snapping as it rolls over a retained lateral femoral condylar osteophyte. Patellar clunk syndrome is a distinct syndrome associated with the patella and has been reported in posterior stabilized knees. In addition to crepitation with range of motion, the patella literally snaps or jumps as the knee is taken from flexion to extension.

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