Return to sports and clinical outcomes in patients treated for peroneal tendon dislocation: a systematic review

Abstract

Purpose The aim of this study was to determine the outcome following different surgical treatment techniques in the treatment of peroneal tendon dislocation and to establish whether return to sports was achieved universally following the procedures.MethodsA systematic review and best-evidence synthesis was performed. PubMed and EMBASE were searched for eligible studies. The last search was done in March 2015. Quality assessment of pooled data was performed using a modified Macleod scale and a best-evidence synthesis was performed. In total, 14 studies were included.ResultsSurgical treatment provides improvement in the post-operative AOFAS score (p < 0.0001) and high satisfaction rates. The redislocation rate is less than 1.5 % at long-term follow-up. Patients treated with both groove deepening and SPR repair have higher rates of return to sports than patients treated with SPR repair alone (p = 0.022).ConclusionsSurgical treatment of peroneal tendon dislocation provides good outcomes, high satisfaction and a quick return to sports. Rates in return to sports are significantly higher in patients treated with both groove deepening and SPR repair. To optimize treatment, the surgical management should involve increasing the superior peroneal tunnel volume by groove deepening and stabilizing the tendons by SPR repair.Level of evidenceLevel IV, systematic review of level IV studies.

The ESSKA-AFAS international consensus statement on peroneal tendon pathologies

“…Multiple management options have been proposed for the treatment of peroneal dislocations, generally aiming to repair or reconstruct the SPR, correct predisposing factors and increase the volume of the peroneal tunnel. While the benefits of surgery have been shown in the literature [ 44 ], the value of conservative management remains unclear. The current evidence is limited to a number of case reports and small retrospective series suggesting that the risk of recurrent peroneal instability is approximately 50% [ 21 ].…”

Tendoscopic Treatment of Peroneal Intrasheath Subluxation: A New Subgroup With Superior Peroneal Retinaculum Injury

“…Snapping of the peroneal tendons can be a disabling condition for young and active individuals. 28,39 This condition is thought to be caused only by either chronic subluxation or intrasheath subluxation. However, as reported in the present study, SPR injury without peroneal tendon dislocation is a possibility, which would account for a novel diagnosed entity.…”

“…Recently, even tendoscopic procedures have shown similar results, with lower risk of complications and recurrence. 3,17,29,30,[37][38][39][40]42 Open surgery for peroneal tendon subluxation requires a large incision and dividing a section of the SPR for a thorough examination. Although reported results are similar, minimally invasive techniques have benefits in terms of morbidity, pain, and cosmetic outcomes, in addition to a faster recovery and less discomfort for the patient.…”

Recurrent Peroneal Tendon Dislocation: A Consecutive Case Series and Review of the Literature

“…Iako Van Dijk i sur. 48 u sistematskom pregledu literature o povratku sportskim aktivnostima i kliničkom ishodu nakon kirurškog liječenja LPT-a u istom kontekstu spomi-nju i komentiraju rezultate liječenja subluksacije peronealnih tetiva u omotaču (engl. intrasheath subluxation of peroneal tendons), ipak mislimo da je riječ o dva entiteta koji se u mnogočem razlikuju pa se niti mogu niti smiju zajedno analizirati.…”