The Journal of Bone and Joint Surgery, Vol 62, Issue 6 973-980, Copyright © 1980 by Journal of Bone and Joint Surgery, Inc
Functional evaluation of the pes anserinus transfer by electromyography and gait analysis
J Perry, JM Fox, MA Boitano, SR Skinner, LA Barnes and K Cerny
The effectiveness of the pes anserinus transfer, proposed by Slocum and
Larson to control anteromedial rotatory instability of the knee, depends on
the pes anserinus muscles contracting at times when the instability
threatens the patient's function. To examine the activity of the
transferred pes anserinus muscles, quantitated dynamic electromyography,
isometric testing of muscle strength, and gait-analysis techniques were
employed. Seven normal subjects and nine patients who had undergone pes
anserinus transfer for anteromedial rotatory instability were tested. In
contrast to the normal subjects, who demonstrated pes anserinus muscle
activity primarily during swing phase, the patients displayed conspicuous
activity of the semitendinosus, gracilis, and sartorius tendons during
stance phase. Quantitated electromyography indicated that the pes anserinus
muscles worked harder in the patients than in the normal subjects, and more
effort was required from the muscles of patients with poor results than
from those of patients with good results. All of the patients also
demonstrated reduction of single-limb support time, as well as a shorter
stride length and reduced gait velocity. We concluded that the pes
anserinus transfer is kinetically sound. Since instability of the knee is a
functional defect that is present during stance, the finding of marked
activity of the pes anserinus muscles during stance phase in the patients
but not in the normal subjects suggests that these muscles were being used
to control the instability.
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