Minimally invasive tenotomy of the tibial insertion of the semitendinosus muscle: an ex vivo study in horses.
Objective: To describe a minimally invasive technique for semitendinosus tenotomy with ultrasonographic guidance and to evaluate procedural complications. Study design: Experimental study. Sample population: Cadaveric equine hind limbs (n = 16). Methods: A stab incision was performed distocaudal to the tibial insertion of the semitendinosus muscle with ultrasonographic assistance. After transection of the tendon with an arthroscopic retrograde knife, the tendon edges palpably retracted, and complete transection was confirmed by ultrasound. Limbs were dissected to confirm the degree of tendon transection and to identify iatrogenic trauma to surrounding soft tissues. Results: Tenotomy was complete in all limbs, resulting in a palpable gap forming between tendon edges. Superficial iatrogenic laceration to the underlying gracilis muscle (n = 2) or gracilis fascia (n = 1) was apparent in 3 of 16 limbs. Conclusion: Ultrasound-assisted tenotomy of the tibial insertion of the semitendinosus muscle was reliably performed in a minimally invasive fashion with minor iatrogenic damage. Clinical significance: Minimally invasive tenotomy of the semitendinosus muscle can be performed with ultrasonographic assistance and should be considered as an alternative technique for surgical management of fibrotic semitendinosus myopathy.