Sliding Fibular Graft Repair for the Treatment of Recurrent Peroneal Subluxation

Zuo, Zhuang; Wang, Jin; Gong, Haifeng; Li, Huanting; Feng, Chen; Li, Ming

doi:10.1177/1071100714523271

Cited by 22 publications

(34 citation statements)

References 26 publications

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“…Eight studies reported on time to RTS, with a number of 168 included patients [ 5 , 12 , 13 , 27 , 33 , 39 , 42 , 43 ]. The time to RTS ranged from 1.2 to 12 months (Table 4 ).…”

Section: Resultsmentioning

confidence: 99%

“…Previous studies have demonstrated that flat or convex retromalleolar grooves may predispose patients to luxation of the peroneal tendons [ 14 , 32 ]. The presence of a peroneus quartus muscle or a low-lying muscle belly makes individuals also more susceptible for peroneal tendon dislocation [ 37 , 42 , 43 ]. Normal anatomy of the lateral ankle is shown in Fig.…”

Section: Introductionmentioning

confidence: 99%

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

Dijk

Gianakos

Kerkhoffs

et al. 2015

Knee Surg Sports Traumatol Arthrosc

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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.

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“…Eight studies reported on time to RTS, with a number of 168 included patients [ 5 , 12 , 13 , 27 , 33 , 39 , 42 , 43 ]. The time to RTS ranged from 1.2 to 12 months (Table 4 ).…”

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Dijk

Gianakos

Kerkhoffs

et al. 2015

Knee Surg Sports Traumatol Arthrosc

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“…Advances in magnetic resonance imaging (MRI) system have enhanced our ability to diagnose soft tissue pathologies such as tenosynovitis and tendon tear. A low lying muscle belly (Figure) is a rare anomaly, most commonly associated with peroneus brevis tendon (1–3). A low lying muscle belly is defined as a muscle extending beyond its normal length.…”

Section: Introductionmentioning

confidence: 99%

“…In the case of a peroneus brevis muscle, it is expected that the muscle would end in average 1.6–2.0 cm above the distal tip of the fibula (4). Cases of low lying peroneus brevis muscle belly (LLMB) has been documented in the literature (1, 3, 5–9). However, to our knowledge, association between a low lying muscle belly and tendon subluxation is not well studied.…”

Section: Introductionmentioning

confidence: 99%

“…Even though the presence of a low lying peroneal muscle belly in cases of peroneal tendon tears has been documented in several studies (1–3), the prevalence of a low lying peroneal muscle and its association with peroneal tendon subluxation is not adequately studied in the available literature. In this study, our primary goal was to determine if there was any association between a low lying peroneus brevis tendon muscle belly and tendon subluxation.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence and Role of a Low-Lying Peroneus Brevis Muscle Belly in Patients With Peroneal Tendon Pathologic Features: A Potential Source of Tendon Subluxation

Mirmiran

Squire

Wassell

2015

The Journal of Foot and Ankle Surgery

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A low lying peroneus brevis muscle belly is a rare anomaly. There are few published studies that support presence of this anomaly as an etiology for peroneal tendon tear. However, the association between a low lying peroneus muscle belly (LLMB) and tendon subluxation is not well explored. In this retrospective study, the magnetic resonance imaging (MRI) and intraoperative findings of 50 consecutive patients undergoing a primary peroneal tendon surgery, in a five year period, were assessed. The sensitivity and specificity of MRI, in comparison to intraoperative findings for identifying peroneal tendon disease was investigated. Presence of associated peroneal tendon pathologies in patients with and without LLMB was compared. Sensitivity of MRI was high in identifying peroneal tenosynovitis (81.58%) and tear (85.71%). Although the sensitivity of MRI for detecting a LLMB (3.23%) and tendon subluxation (10.00%) was low, MRI had high specificity at 94.74% and 100%, respectively. Intraoperatively, LLMB was seen in 62.00% of patients with chronic lateral ankle pain and was associated with 64.52% cases of tenosynovitis, 29.03% cases of tendon subluxation, and 80.65% cases of peroneus brevis tendon tear. While presence of a LLMB did not show any statistically significant association with peroneus brevis tendon subluxation, among the 10 patients with intraoperatively observed tendon subluxation, 9 had a concomitant LLMB. More studies with a larger patient population are needed to better study the role of a low lying muscle belly as a mass occupying lesion resulting in peroneal tendon subluxation.

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The Ankle Ligament Reconstruction‐Return to Sport after Injury (ALR‐RSI) is a valid and reliable measure to assess psychological readiness before returning to sport following peroneal tendon pathology surgery

Saliba,

Dagher,

Valentin

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeThe objective of this study was to validate a scale that could help surgeons evaluate patients' psychological readiness to return to sport (RTS) after peroneal tendon pathology surgery.MethodsThe Ankle Ligament Reconstruction‐Return to Sport after Injury (ALR‐RSI) scale, which had previously been validated in ankle ligament reconstruction patients, was adapted to evaluate the psychological preparedness for RTS in athletic patients who underwent peroneal tendinopathy surgery. The Foot and Ankle Outcome Score (FAOS) and Foot Ankle Ability Measurement (FAAM) scores were employed as patient‐related outcome measurement (PROM) instruments.ResultsThis study included 57 patients. There was a strong correlation between ALR‐RSI and both FAOS and FAAM (r = −0.68 and 0.74, respectively). ALR‐RSI was considerably higher in patients who returned to sports than in those who did not. The mean score was 72.9 ± 19.0 in patients who returned to the same preinjury level, 48.5 ± 24.0 in those who returned to a lower level and 53.6 ± 31.1 in patients who changed their athletic activity (p < 0.0001). Furthermore, ALR‐RSI showed at least a similar discrimination ability when compared to FAOS and FAAM. The test–retest intraclass correlation coefficient was 0.95. The Cronbach's α statistic used to measure the internal consistency was high (0.95). A Youden index of 0.65 was observed for a cut‐off score of 68 points.ConclusionALR‐RSI is a valid instrument for assessing psychological readiness to RTS in an athletic population following peroneal tendon surgery. When compared to the most commonly used PROMs, it was strongly correlated and demonstrated at least similar discrimination capacity. This could assist surgeons in identifying athletes who will have poor postoperative results and advising them on their capability to RTS.Level of EvidenceLevel III.

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Sliding Fibular Graft Repair for the Treatment of Recurrent Peroneal Subluxation

Abstract: Level III, retrospective comparative study.

Cited by 22 publications

References 26 publications

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

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

Prevalence and Role of a Low-Lying Peroneus Brevis Muscle Belly in Patients With Peroneal Tendon Pathologic Features: A Potential Source of Tendon Subluxation

The Ankle Ligament Reconstruction‐Return to Sport after Injury (ALR‐RSI) is a valid and reliable measure to assess psychological readiness before returning to sport following peroneal tendon pathology surgery

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