Semimembranosus tendonitis after total knee arthroplastyGood outcome after surgery in 6 patients

Distal semimembranosus tendinopathy: A narrative review

Distal semimembranosus tendinopathy is a relatively uncommon diagnosis that can be responsible for medial knee pain. The semimembranosus tendon inserts on the posteromedial knee and is surrounded by the semimembranosus bursa, with both the bursa and tendon potential sources of pain. Similar to other tendinopathies, semimembranosus tendinopathy often occurs with overuse of the musculotendinous unit and is commonly seen in runners. Diagnosis can be made clinically and may be substantiated with use of ultrasound or magnetic resonance imaging. Scant literature exists evaluating the efficacy of treatments for this condition. Consequently, best practice for treatment is inferred from other similar tendinopathies, clinical expertise, and smaller studies on semimembranosus tendinopathy. Extrapolating from other tendinopathies, rehabilitation should be the cornerstone of initial treatment, with focus on kinetic chain and gait abnormalities, hamstring strength and neuromuscular control, and progressive tendon loading. Recalcitrant cases with a coexisting bursopathy can be treated with an ultrasound-guided bursal corticosteroid injection. Future studies may help delineate the optimal treatment regimen for this relatively uncommon diagnosis.

Semimembranosus tendinopathy: one cause of chronic posteromedial knee pain

Context:

Semimembranosus tendinopathy (SMT) is an uncommon cause of chronic knee pain that is rarely described in the medical literature and may be underdiagnosed or inadequately treated owing to a lack of understanding of the condition.

Evidence Acquisition:

A search of the entire PubMed (MEDLINE) database using the terms knee pain semimembranosus and knee tendinitis semimembranosus, returned only 5 references about SMT—4 case series and 1 case report—and several relevant anatomical or imaging references.

Results:

The incidence of SMT is unknown in the athletic population and is probably more common in older patients. The usual presentation for SMT is aching posteromedial knee pain. Physical examination can usually localize the area of tenderness to the distal semimembranosus tendon or its insertion on the medial proximal tibia. In unclear cases, bone scan, magnetic resonance imaging, or ultrasound may distinguish SMT from other causes of posteromedial knee pain. Treatment should begin with relative rest, ice, nonsteroidal anti-inflammatory drugs, and rehabilitative exercise. In the minority of cases that persist greater than 3 months, a corticosteroid injection at the tendon insertion site may be effective. Surgery to reroute and reattach the tendon is rarely needed but may be effective.

Conclusion:

SMT is an uncommon cause of knee pain, but timely diagnosis can lead to effective treatments.

Biceps tendinitis as a cause of acute painful knee after total knee arthroplasty

The case report highlights an unusual case of posterolateral knee pain after total knee arthroplasty. Tendinitis of the patellar tendon or pes anserinus is a common complication after total knee arthroplasty; however, there is no report in the literature regarding the biceps femoris tendinitis causing acute pain in the early postoperative period. In this case, the biceps tendinitis was diagnosed and treated by ultrasound-guided injection into the tendon sheath.