Minimally invasive tenotomy of the tibial insertion of the semitendinosus muscle: An ex vivo study in horses.
Authors: Zetterström Sandra M, Boone Lindsey H, Weatherall Kathleen M, Caldwell Fred J
Journal: Veterinary surgery : VS
Summary
# Minimally Invasive Semitendinosus Tenotomy: A Viable Surgical Approach Fibrotic semitendinosus myopathy represents a significant cause of hindlimb lameness and performance loss in horses, yet traditional surgical approaches carry considerable morbidity. Zetterström and colleagues evaluated an ultrasound-guided, minimally invasive tenotomy technique on 16 cadaveric equine hindlimbs, using a small stab incision distocaudal to the tibial insertion combined with an arthroscopic retrograde knife for transection. All 16 limbs achieved complete tenotomy with palpable gap formation confirmed ultrasonographically, though subsequent dissection revealed superficial iatrogenic trauma to the gracilis muscle or its fascia in 3 limbs (19%), representing minor collateral damage to adjacent soft tissues. The technique's reliability and reduced invasiveness make it a compelling alternative to conventional open approaches, potentially offering improved recovery profiles and reduced postoperative complications for clinical patients, though validation in live animals and long-term outcome data remain necessary before widespread adoption.
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Practical Takeaways
- •Ultrasound-guided minimally invasive semitendinosus tenotomy is a technically feasible alternative to open surgical approaches for managing fibrotic semitendinosus myopathy
- •Minor iatrogenic damage to adjacent gracilis structures occurs occasionally but appears clinically insignificant; surgeons should be aware of this anatomical relationship during the procedure
- •This ex vivo validation supports clinical trial consideration, though in vivo efficacy and long-term functional outcomes remain to be evaluated
Key Findings
- •Complete tenotomy was achieved in all 16 cadaveric limbs using ultrasound-guided minimally invasive technique with palpable gap formation between tendon edges
- •Superficial iatrogenic laceration to gracilis muscle or fascia occurred in 3 of 16 limbs (18.75%), representing minor collateral soft tissue trauma
- •The technique was reliably performed via a stab incision distocaudal to the tibial insertion using an arthroscopic retrograde knife