2023-11-08 13:00:03
Every week, Dr Jean-Marc Sène, sports doctor, presents his sports column in Priorité Santé. Today, he tells us about a little-known pathology, the trapped popliteal artery.
Published on: 08/11/2023 – 12:00
2 mn
The popliteal artery is the artery that supplies oxygenated blood to the knee joint, the muscles surrounding the knee, the leg and the foot. It can be felt on the posterior surface of the knee in the popliteal fossa: this is the popliteal pulse. It follows the femoral artery and then divides into two arteries at the upper part of the tibia: the anterior tibial artery and the posterior tibial artery.
Entrapped popliteal artery syndrome where the popliteal artery is compressed by nearby muscular and aponeurotic structures.
Syndrome of compression of the popliteal artery by a tendon of the knee muscles. The popliteal trap results from an embryological anomaly, either arterial or muscular (by abnormal insertion of the muscles). It is a relatively rare pathology (0.16 to 3%) but underestimated, which rather affects young men (50% are under 30 years old). Often bilateral, the syndrome affects athletes, with hypertrophy of the calf muscles (dance, basketball, swimming, cycling)
What are the symptoms that should make us think about it?
The anatomical anomaly is responsible for intermittent postural compression of the artery responsible for intermittent pain in the leg when walking. The notion of cramp sensation during exercise is more obvious in athletes, but it may be a symptom that simply manifests itself when walking when the anatomical trap is significant.
This can also be expressed by:
Plantar pain or paresthesia (tingling) from associated compression of the tibial nerve Swelling of the leg and foot from associated compression of the popliteal vein Painful discomfort with prolonged flexion of the knee.
How to make a diagnosis?
Your doctor’s physical examination will probably be normal at rest. Which is a source of diagnostic delay. Your doctor may request a Doppler ultrasound examination which can authenticate a probable popliteal arterial trap and its consequences on arterial flow. An MRI can help detect anatomical abnormalities of the popliteal fossa (for example aneurysm) and an MRI angiogram perfectly visualizes anatomical arterial stenoses.
It is more complicated for functional anatomical stenoses (under stress) which require sustained muscular contraction throughout image acquisition.
How is this treated?
It depends on the origin of the compression of the artery. Surgical treatment is generally proposed, especially in the event of an anatomical anomaly allowing the trapped artery to be released from musculo-tendinous constraint. The procedure consists of simply releasing the soleus arch, at the cost of a long scar and a sports rest of 2 to 3 months.
New non-surgical avenues are beginning to emerge with botulinum toxin in order to paralyze the muscle responsible for the compression.
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