Allograft Reconstruction of Peroneal Tendons

Mook, William R.; Parekh, Selene G.; Nunley, James A.

doi:10.1177/1071100713487527

Cited by 69 publications

(12 citation statements)

References 36 publications

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“…No studies were found with the primary focus on rehabilitation of surgically treated peroneal tendon tears or ruptures. Included studies described their rehabilitation method after one or more of the following surgical treatment methods: group A: primary repair with or without tubularization of the tendon, [ 1 , 2 , 6 , 7 , 12 – 14 , 19 , 23 – 28 , 31 , 36 , 39 , 43 , 47 – 50 , 53 , 56 , 61 , 62 , 65 , 69 ] group B: tenodesis, [ 1 , 2 , 4 , 5 , 10 , 14 , 16 , 25 , 30 , 40 , 43 , 44 , 46 , 47 , 49 , 50 , 61 , 62 , 67 , 69 ] group C: grafting [ 8 , 10 , 21 , 29 , 34 , 37 , 38 , 42 , 43 , 45 , 46 , 49 , 50 , 61 , 69 ] and group D: end-to-end suturing [ 1 , 29 , 41 , 43 , 47 , 66 , 68 ]. Fourteen studies reported two or more surgical treatment methods [ 10 , 25 , 29 , 43 , 4...…”

Section: Resultsmentioning

confidence: 99%

“…Rehabilitation after surgical treatment with grafting was reported in 16 studies [ 8 , 10 , 21 , 29 , 34 , 37 , 38 , 42 , 43 , 45 , 46 , 47 , 49 , 50 , 61 , 69 ] with a median immobilization period of 6.3 (range 3.0–13) weeks (Table 2 ). Of the studies ( n = 15) that reported on the start of ROM, 7 studies (47 %) reported on a start within 4 weeks post-operative [ 10 , 34 , 45 – 47 , 61 , 69 ].…”

Section: Resultsmentioning

confidence: 99%

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Rehabilitation after surgical treatment of peroneal tendon tears and ruptures

Dijk

Lubberts

Verheul

et al. 2016

Knee Surg Sports Traumatol Arthrosc

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PurposeThe purpose of this study was to provide an overview of the available evidence on rehabilitation programmes after operatively treated patients with peroneal tendon tearsand ruptures.MethodsA systematic review was performed, and PubMed and EMBASE were searched for relevant studies. Information regarding the rehabilitation programme after surgical management of peroneal tendon tears and ruptures was extracted from all included studies.ResultsIn total, 49 studies were included. No studies were found with the primary purpose to report on rehabilitation of surgically treated peroneal tendon tears or ruptures. The median duration of the total immobilization period after primary repair was 6.0 weeks (range 0–12), 7.0 weeks (range 3.0–13) after tenodesis, 6.3 weeks (range 3.0–13) after grafting, and 8.0 weeks (range 6.0–11) after end-to-end suturing. Forty one percent of the studies that reported on the start of range of motion exercises initiated range of motion within 4 weeks after surgery. No difference was found in duration of immobilization or start of range of motion between different types of surgical treatment options.ConclusionAppropriate directed rehabilitation appears to be an important factor in the clinical success of surgically treated peroneal tendon tears and ruptures. There seems to be a trend towards shorter immobilization time and early range of motion, although there is no consensus in the literature on best practice recommendations for optimizing rehabilitation after surgical repair of peroneal tendon tears or ruptures. It is important to adjust the rehabilitation protocol to every specific patient for an optimal rehabilitation.Level of evidence Systematic Review, Level IV.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Rehabilitation after surgical treatment of peroneal tendon tears and ruptures

Dijk

Lubberts

Verheul

et al. 2016

Knee Surg Sports Traumatol Arthrosc

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“…Several surgical procedures to repair tendon ruptures are reported in the literature, yet no clear consensus on the best technique or rehabilitative protocol exists. [1,3,11] Based on the severity of peroneal tendon rupture (e.g., partial-thickness split versus full-thickness split), treatment protocols vary from conservative treatment—including rest, ice, compression, and elevation—to invasive or percutaneous surgical repair. [12] While surgical repair has proven to be effective, it has been reported that as many as 25.4% of patients struggle with post-op complications such as pain, and 17.4% experience persistent swelling.…”

Section: Discussionmentioning

confidence: 99%

“…Peroneal tendon injuries are associated with debilitating complications—such as chronic ankle instability, foot deformities, chronic pain, and bone spurs [1] —thus, prompt diagnosis and repair are crucial for optimizing clinical outcomes. Initially, pain levels contribute to extended lengths of post-operative (post-op) rehabilitation while development of tissue adhesions and fibrosis limit long-term functionality through reduced range of motion.…”

Section: Introductionmentioning

confidence: 99%

“…In recent years, several surgical techniques and protocol algorithms for tendon repair have been proposed incorporating various augmentative graft materials. [1–3] Cases of acellular allograft use in tendon repair have been presented in the literature, [4–6] many soliciting unwanted inflammatory reactions, [7–9] yet reports on the use or outcomes of viable cellular allografts in tendon repair are scarce.…”

Section: Introductionmentioning

confidence: 99%

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A quality improvement pilot assessment of the safety and associated outcomes of a viable cryopreserved umbilical tissue allograft as an adjunct surgical wrap in peroneus brevis tendon repair

Sundblad¹,

Tassis

2018

Medicine

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Surgical tendon repairs of the lower extremity are frequently associated with post-operative (post-op) risks that result in poor patient outcomes. Initially, increased pain levels may contribute to extended post-op rehabilitation while the development of tissue adhesions and fibrosis limit long-term functionality through reduced range of motion. Several surgical methods describing incorporation of various augmentative graft materials in tendon repair exist. However, reports demonstrating technique and both short- and long-term patient outcomes are lacking. Recently, advances in tissue preservation technology have led to the commercialization of human placental allografts. Of these available allogeneic biomaterials, the components found in human placental membranes may provide anti-inflammatory, antimicrobial, anti-adhesive, and antifibrotic properties to benefit surgical outcomes.Here, the authors introduce and technically describe the use of a viable cryopreserved umbilical tissue (vCUT) (Stravix, Osiris Therapeutics, Inc., Columbia, MD) as a complementary surgical wrap in primary tendon repair, with particular focus on the peroneus brevis. A pilot study was undertaken to assess the safety and potential for secondary rehabilitative outcomes associated with the use of vCUT in 5 tendon repair cases. The use of vCUT as a surgical tendon wrap was evaluated via the following primary endpoints at post-op day 7:1. presence of erythema, tenderness, heat and/or swelling;2. pain score;3. patient use of narcotic medication; and4. the development of adverse events during any point during the post-op course, defined in this study as dehiscence, confirmed infection, fluid collection or drainage.Secondary investigative endpoints included clinical and rehabilitative outcome measures for comparative pain reduction and transition times to both controlled ankle movement (CAM) boot and normal shoe ambulation.All patients were followed for an average of 24.15 months (range 16.75–26.5 months) after surgery. For primary safety measures, erythema, tenderness, drainage, heat, and swelling was absent in all 5 surgical sites. None of the patients required post-op use of narcotics past day 7. The potential for long-term rehabilitative improvement with adjunct use of vCUT was also demonstrated through reduced pain and reduced transition times to functional and non-assisted ambulation in normal shoewear as compared to historical controls managed without vCUT.This surgical technique is simple and safe for patients and preliminary findings have demonstrated favorable clinical and rehabilitative outcomes over historically observed controls.

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