Melton Joel K, Memarzadeh Arman, Dunbar William H, Cross Mervyn J
Orthopaedic Department, Addenbrooke's Hospital, Cambridge CB2 0QQ, UK.
Orthopaedic Department, Addenbrooke's Hospital, Cambridge CB2 0QQ, UK.
Knee. 2017 Mar;24(2):305-309. doi: 10.1016/j.knee.2016.10.012. Epub 2016 Dec 28.
In orthopedic and sports medicine literature there is minimal information regarding accurate diagnosis and the treatment options for tenosynovitis of the distal semimembranosus tendon. After reviewing the literature, the authors question both the etiology and treatment of this condition. Previous descriptions have associated the condition primarily with the endurance athlete but we have noted multiple cases in which this is a condition common to the 'sprinter' as well. There has been very little mention of this condition in recent literature but the most recent complete description of operative treatment for this condition recommends both tendon transfer and concomitant arthroscopy. We propose this condition is akin to De Quervain's tenosynovitis of the knee, with sensitive and specific signs on physical examination.
We describe a case series of six cases (five patients), that underwent open surgical release for semimembranosus tenosynovitis. The anatomy and the treatment options for the condition are also discussed.
At a follow-up period of 18-64months, all cases showed improvement in the Tegner activity score following surgical release.
Diagnostic confusion can be decreased with more modern diagnostic imaging modalities than those described in the literature. The authors outline an alternative operative approach significantly decreasing surgical complexity and therefore post-operative morbidity. What is known about this subject: This is a rare condition and the surgical treatment is seldom performed. What this study adds to existing knowledge: We describe the technique for surgical decompression and reveal positive results at medium term follow-up.
在骨科和运动医学文献中，关于半膜肌远端肌腱腱鞘炎的准确诊断和治疗选择的信息极少。在查阅文献后，作者对这种疾病的病因和治疗提出了疑问。以往的描述主要将这种疾病与耐力运动员联系在一起，但我们注意到在多个病例中，短跑运动员也很常见这种情况。近期文献中很少提及这种疾病，但关于这种疾病手术治疗的最新完整描述推荐了肌腱转移和同时进行关节镜检查。我们认为这种疾病类似于膝关节的德·奎尔万腱鞘炎，体格检查时有敏感且特异的体征。
我们描述了一组6例（5名患者）因半膜肌腱鞘炎接受开放性手术松解的病例系列。还讨论了该疾病的解剖结构和治疗选择。
在18 - 64个月的随访期内，所有病例在手术松解后Tegner活动评分均有改善。
与文献中描述的相比，采用更现代的诊断成像方式可减少诊断困惑。作者概述了一种替代手术方法，可显著降低手术复杂性，从而降低术后发病率。关于该主题的已知信息：这是一种罕见疾病，很少进行手术治疗。本研究对现有知识的补充：我们描述了手术减压技术，并在中期随访中显示出积极结果。
