Strength of Interference Screw Fixation to Cuboid vs Pulvertaft Weave to Peroneus Brevis for Tibialis Posterior Tendon Transfer for Foot Drop

Marsland, Daniel; Stephen, Joanna M.; Calder, Toby; Amis, Andrew A.; Calder, James

doi:10.1177/1071100718762442

Cited by 12 publications

(11 citation statements)

References 39 publications

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“…Several studies have compared different methods of fixation. Marsland et al 6 compared PTW to IS (5.5 × 15 mm) used for tibialis posterior tendon transfer to the cuboid in a cadaveric model. Similar to our results, they showed no difference in mean displacement between both techniques under cyclic loading (2.9 ± 2.5 mm for PTW vs 2.4 ± 1.1 mm for IS; P = .35).…”

Section: Discussionmentioning

confidence: 99%

“…The specimen was placed on the machine so that the direction of the load would be in line with the physiological line of pull of the peroneus brevis tendon. 6…”

Section: Methodsmentioning

confidence: 99%

“…The specimen was placed on the machine so that the direction of the load would be in line with the physiological line of pull of the peroneus brevis tendon. 6 Three testing protocols were applied to each specimen. First, we measured the force/displacement slope of the native tendon using cyclic loading prior to any reconstruction.…”

Section: Specimen Testingmentioning

confidence: 99%

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Load to Failure and Stiffness of Interference Screw vs Pulvertaft Weave for Distal Fixation in Peroneal Allograft Reconstruction

et al. 2020

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Background: Allograft reconstruction of the peroneal tendons is an option for treatment of major tears of 1 or both peroneal tendons. No consensus on a superior distal fixation method has been reported. The purpose of the study was to compare load to failure and stiffness of a Pulvertaft weave (PTW) through a residual tendon stump to direct-to-bone interference screw (IS) fixation. Methods: Fifteen pairs of long leg cadaver specimens were used. All grafts were secured proximally to the peroneus brevis myotendinous junction via a PTW technique. Distally, the tendons were either sutured to the peroneus brevis stump via PTW or secured to the base of the fifth metatarsal via IS. Stiffness (slope of force/displacement) was measured for the intact tendon and after reconstruction, and finally each specimen was loaded to failure. Results: Mean load to failure was significantly higher in the PTW group compared with the IS group (373.6 ± 265.5 N vs 150.1 ± 93.1 N; P = .01). The PTW and IS groups had significantly lower stiffness compared with the intact specimens ( P < .001). There was no statistical significance in stiffness between the 2 techniques ( P = .96). Conclusion: The PTW technique yielded higher load to failure in comparison to IS. There was no difference in overall construct stiffness between both techniques. Both constructs demonstrated 19% decrease in stiffness compared to the intact state. Clinical Relevance: The PTW and IS constructs were biomechanically similar, and these results suggest that both should be moderately overtensioned to compensate for an inherent decreased initial stiffness.

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Section: Discussionmentioning

confidence: 99%

“…The specimen was placed on the machine so that the direction of the load would be in line with the physiological line of pull of the peroneus brevis tendon. 6…”

Section: Methodsmentioning

confidence: 99%

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Load to Failure and Stiffness of Interference Screw vs Pulvertaft Weave for Distal Fixation in Peroneal Allograft Reconstruction

et al. 2020

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“…Their use minimizes the risk of wound complications or skin ulcerations in comparison to staples or button fixation on the plantar surface. Additionally, compared to tendon fixation or fixation through bone tunnels, the use of a shorter tendon graft is sufficient and less surgical dissection is required [26][27][28][29][30]. The outcomes of the Marsland et al [27] study find that the strengths of both, interference screw (bone) fixation and Pulvertaft weave (tendon) fixation of the posterior tibial tendon were comparable.…”

Section: Operative Techniquesmentioning

confidence: 99%

Tendon transfer in foot drop: a systematic review

Stevoska

Pisecky

Stadler

et al. 2021

Arch Orthop Trauma Surg

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Introduction Foot drop is a disorder that impairs walking and leads to tripping and falling. Tendon transfer (e.g., tibialis posterior tendon) is a typical secondary procedure in foot drop treatment. The purpose of this systematic review was to identify the most common tendon transfer techniques for treating foot drop and to analyze the reported functional outcomes. Furthermore, it was of interest if the type of surgical technique affects the functional outcome. Methods A PubMed and MEDLINE literature search was performed according to PRISMA guidelines. The search terms used were (“tendon transfer” OR “tendon transposition”) AND (“foot drop” OR “peroneal neuropathies”). Any study published before January 2020 was considered for inclusion. No case reports or reviews were included. Common outcome measures (Stanmore score, AOFAS, FAAM, AFO use, patient satisfaction and active ankle dorsiflexion) were evaluated. The quality of the included studies was assessed using the Coleman Methodology Score. Results Of the 125 reviewed publications, 37 met the inclusion criteria. 42 cohorts were analyzed. The frequently reported tendon transfer technique was the tibialis posterior tendon transfer through the interosseus membrane. The most used fixation technique was tendon on tendon fixation; however in recent years, a tendon to bone fixation has gained popularity. There was an increase in Stanmore scores and AOFAS postoperatively and a decrease of AFO use postoperatively observed. Conclusions Due to various outcome measures and lack of preoperative assessment in the included studies, a meta-analysis of the pooled results was not possible. Nevertheless, the findings of this study show that tendon transfer increases mobility and self-independency leading to patient satisfaction. The choice of the surgical technique does not affect the outcome. A prospective collection of patient data and standardized outcome measures will be important to further analyze the efficacy of tendon transfer techniques.

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“…This surgical technique is commonly performed in foot and ankle as well as in hand and plastic surgery. Common examples include the treatment of patients with common peroneal nerve palsy (foot drop) and insertional or noninsertional tendinopathy of the Achilles tendon [ 3 , 4 ]. Moreover, side-to-side tenorrhaphies are used to restore critical grasping motions of the hand after brachial plexus palsy [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Fine tuning of the side-to-side tenorrhaphy: A biomechanical study assessing different side-to-side suture techniques in a porcine tendon model

et al. 2021

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Recent studies conclude that a new technique for tendon transfers, the side-to-side tenorrhaphy by Fridén (FR) provides higher biomechanical stability than the established standard first described by Pulvertaft (PT). The aim of this study was to optimize side-to-side tenorrhaphies. We compared PT and FR tenorrhaphies as well as a potential improvement, termed Woven-Fridén tenorrhaphy (WF), with regard to biomechanical stability. Our results demonstrate superior biomechanical stability and lower bulk of FR and, in particular, WF over PT tenorrhaphies. The WF and FR technnique therefore seem to be a notable alternative to the established standard tenorrhaphy as they display lower bulk and higher stability, permitting successful immediate active mobilization after surgery.

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Strength of Interference Screw Fixation to Cuboid vs Pulvertaft Weave to Peroneus Brevis for Tibialis Posterior Tendon Transfer for Foot Drop

Abstract: The results indicate that early active dorsiflexion and protected weightbearing may be safe for clinical evaluation, with potential benefits for the patient compared with cast immobilization.

Cited by 12 publications

References 39 publications

Load to Failure and Stiffness of Interference Screw vs Pulvertaft Weave for Distal Fixation in Peroneal Allograft Reconstruction

Load to Failure and Stiffness of Interference Screw vs Pulvertaft Weave for Distal Fixation in Peroneal Allograft Reconstruction

Tendon transfer in foot drop: a systematic review

Fine tuning of the side-to-side tenorrhaphy: A biomechanical study assessing different side-to-side suture techniques in a porcine tendon model

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