Halperin N, Oren Y, Hendel D, Nathan N
Arch Orthop Trauma Surg (1978). 1987;106(5):281-4. doi: 10.1007/BF00454334.
Semimembranosus tenosynovitis is a common knee problem in the over-50 age-group, occurring mainly in women. It affects the reflected portion of the tendon of the semimembranosus muscle as well as the bursa below it. The tendon becomes inflamed as a result of friction at the entrance to the bony canal (semimembranosus groove), especially if osteophytes are present on the edges of the groove. Conservative treatment includes anti-inflammatory drugs, ultrasound, and friction massage. If necessary, nonresponders may be given local injection of 40-80 mg methylprednisolone acetate with 1% Xylocaine. Between 1979 and 1983 we operated on 16 patients who had not obtained relief even after three or four injections. The approach in each case was through a posterior medial oblique incision. The semimembranosus osteofibrotic tunnel was revealed and the fibrous sheath surrounding the tendon was excised. Good results were obtained in eight patients in whom the inflammatory process had been localized to only the semimembranosus insertion area: eight patients in whom the knee joint or the pes anserinus insertion was also involved achieved fair or poor results. The operation is not advised for young athletes because of the important function of the reflected head of the semimembranosus muscle.
半膜肌腱鞘炎是50岁以上人群中常见的膝关节问题，主要发生在女性。它影响半膜肌肌腱的折返部分及其下方的滑囊。由于在骨性管道（半膜肌沟）入口处的摩擦，尤其是当沟边缘有骨赘时，肌腱会发炎。保守治疗包括使用抗炎药物、超声和摩擦按摩。必要时，对无反应者可局部注射40 - 80毫克醋酸甲泼尼龙加1%利多卡因。1979年至1983年间，我们对16例即使经过三四次注射仍未缓解的患者进行了手术。每例手术均通过后内侧斜切口进行。显露半膜肌骨纤维隧道并切除围绕肌腱的纤维鞘。8例炎症仅局限于半膜肌附着区的患者取得了良好效果：8例膝关节或鹅足附着区也受累的患者效果一般或较差。由于半膜肌折返头的重要功能，不建议年轻运动员进行该手术。
