This video emphasizes the clinical difference between functional popliteal artery entrapment (FPAES) and anatomic popliteal artery entrapment syndrome (APAES) and demonstrates the surgical procedure which successfully corrects functional entrapment.

FPAES most commonly results from overuse injury in physically active young adults and presents with posterior calf claudication and plantar paraestheisas. FPAES is not associated with musculotendinous anomalies or vascular complications and requires surgical treatment distinctly different from that used to treat APAES.

Between 1987-2000, 57 patients have been treated for popliteal entrapment syndrome (43 FPAES=75%, 14 APAES=25%). Most FPAES patients were female (33=78%), mean age 24 years. APAES patients were older males (10=71%), mean age 44 years. The FPAES operation employs a medial calf incision with gastrocnemius fasciectomy and resection of the soleus muscle fascia. APAES surgery included a posterior knee exposure, resection of musculotendinous anomalies, and vascular repair if necessary. All FPAES patients had symptomatic relief without recurrence. Minor wound problems occurred in 6%. Follow up range between 12-200 months.

FPAES is more common than APAES and requires a unique operation for relief of symptoms.