1. Semimembranosus Tendon Advancement for the Anteromedial Knee Rotatory Instability Treatment
- Author
-
Gustavo Kenzo Miyashita, Leonardo Addêo Ramos, Jorge Liozi Yamashita, Bruno Asprino Ciancio, and Marcelo Alves Barbosa
- Subjects
medicine.medical_specialty ,Rotatory instability ,business.industry ,Medial approach ,Technical Note ,Medicine ,Ligament injury ,Orthopedics and Sports Medicine ,Anatomy ,Semimembranosus tendon ,musculoskeletal system ,business ,Surgery - Abstract
Injury to the medial compartment of the knee is the most common ligament injury to this joint. The medial approach must consider the presence of associated anteromedial instability. Untreated injury of these instabilities can result in failure of the other reconstructed ligaments. As treatment is usually associated with other ligaments, it is relevant that the technique could save grafts and synthetic material. This article aims to describe a technique for the treatment of anteromedial instabilities through semimembranosus tendon tenodesis in a more anterior and distal position, promoting the tensioning of the posteromedial structures., Technique Video Video 1 Reconstruction of a posteromedial structure of a left knee. The patient is in a supine position. The medial approach starts over the medial epicondyle up to 7 cm distal to the joint interline in the medial tibia surface. At this moment, the semitendinosus and gracilis tendons are removed and prepared to serve as a graft for the (MCLs). The direct tibial insertion of the semimembranosus (SM) tendon is individualized and reinserted from the tibia. Anterodistalization of this tendon is carried out, and posterior oblique ligament is tensioned on this anchor with knee flexed at 5°, neutral rotation, and without adduction. Finally, the MCLs are reconstructed and fixed in 30° of flexion using interference screws.
- Published
- 2021