Patient-Reported Outcomes and Return to Activity After Peroneus Brevis Repair

Steginsky, Brian; Riley, Aimee; Lucas, Douglas E.; Philbin, Terrence M.; Berlet, Gregory C.

doi:10.1177/1071100715611960

Cited by 17 publications

(21 citation statements)

References 12 publications

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“…[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. [2] The optimal surgical technique would be one that prevents complications effectively and allows patients to resume normal activities in a reduced amount of time.…”

Section: Discussionmentioning

confidence: 99%

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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Section: Discussionmentioning

confidence: 99%

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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“…Injury of the peroneal tendons should be considered in any patient presenting with chronic lateral ankle symptoms. Often associated with other concomitant ankle disease, abnormalities of the peroneal tendons may be overlooked in up to 40% of cases (13)(14)(15)(16). Of patients with identified peroneal tendon disease, an estimated 15%-44% will have associated ligamentous instability of the lateral ankle (13,14,17).…”

Section: Peroneus Longus and Brevis Tendonsmentioning

confidence: 99%

“…Often associated with other concomitant ankle disease, abnormalities of the peroneal tendons may be overlooked in up to 40% of cases (13)(14)(15)(16). Of patients with identified peroneal tendon disease, an estimated 15%-44% will have associated ligamentous instability of the lateral ankle (13,14,17). The peroneus brevis (PB) is the primary evertor of the foot and is more commonly subject to tendon injury than the peroneus longus (PL) (14,18).…”

Section: Peroneus Longus and Brevis Tendonsmentioning

confidence: 99%

“…The peroneal tendon sheath is anchored by the superior peroneal retinaculum at the level of the retrofibular groove and by the inferior peroneal retinaculum more distally at the level of the peroneal tubercle (14,17,18). The close confines of the peroneal tunnel can predispose to tendon disease, especially in the presence of accessory and low-lying muscle bellies (13,14,19). The presence of an accessory peroneus quartus muscle belly in the retrofibular groove doubles the likelihood of a PB tendon tear (17).…”

Section: Peroneus Longus and Brevis Tendonsmentioning

confidence: 99%

“…Surgical treatment of PB tendon injury is dictated by the severity of injury and the amount of healthy tendon remaining (14). When chronic tearing involves less than 50% of the tendon's cross-sectional diameter, the damaged tissue can be débrided and the remaining tendon is tubularized using sutures (13,(15)(16)(17)(18)20).…”

Section: Peroneal Tendon Tubularization and Tenodesismentioning

confidence: 99%

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CT and MR Imaging of the Postoperative Ankle and Foot

LiMarzi¹,

Scherer²,

Richardson³

et al. 2016

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A variety of surgical procedures exist for repair of both traumatic and degenerative osseous and soft-tissue pathologic conditions involving the foot and ankle. It is necessary for the radiologist to be familiar with these surgical procedures, so as to assess structural integrity, evaluate for complicating features, and avoid diagnostic pitfalls. Adequate interpretation of postoperative changes often requires access to surgical documentation to evaluate not only the surgery itself but the expected timeline for resolution of normal postoperative changes versus progressive disease. Appropriate use of surgical language in radiology reports is another important skill set to hone and is instrumental in providing a high-quality report to the referring surgeons. The pathophysiology of a myriad of surgical complaints, beginning from the Achilles tendon and concluding at the plantar plate, are presented, as are their common appearances at computed tomography and magnetic resonance imaging. Commonly encountered entities include Achilles tendon tear, spastic equinus, nonspastic equinus, talar dome osteochondral defect, tarsal tunnel syndrome, plantar fasciitis, pes planovalgus, pes cavovarus, peroneal tendinosis, lateral ligament complex pathology, Morton neuroma, plantar plate tear, and metatarsophalangeal joint instability. Computer-generated three-dimensional models are included with many of the procedures to provide a more global view of the surgical anatomy. Correlation with intraoperative photographs is made when available. When appropriate, discussion of postoperative complications, including entities such as infection and failure of graft integration, is presented, although a comprehensive review of postoperative complications is beyond the scope of this article. Notably absent from the current review are some common foot and ankle procedures including hallux valgus and hammertoe corrections, as these are more often evaluated radiographically than with cross-sectional imaging. RSNA, 2016.

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