The extensive use of semantic annotations in the medical domain to enhance information retrieval or encode clinical notes to improving information reuse and sharing demands for high quality annotations generation and services for guaranteeing their validity over time. In this paper we present the extension of an existing framework supporting the (semi-)automatic maintenance of semantic annotations rendered outdated by the evolution of the knowledge organization sys-tem they are extracted from. This is done by the adding new rules and improving existing ones to overcome some shortcomings of the framework. We also propose an experimental evaluation of the extension using seven successive versions of four standard controlled terminologies within the domain.