Posterior Arthroscopic Treatment of a Massive Effusion in the Flexor Hallucis Longus Tendon Sheath Associated with Stenosing Tenosynovitis and Os Trigonum

Tonogai, Ichiro; Sairyo, Koichi

doi:10.1155/2020/6236302

Cited by 2 publications

(5 citation statements)

References 19 publications

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“…Plantar flexion of the first metatarsophalangeal joint and the first finger interphalangeal joint is the primary function of the FHL tendon. Its secondary function is to support the subtalar joint and thumb joints and restrict passive dorsiflexion of the first metatarsophalangeal joint [4,9]. When the ankle is excessively plantar flexed, angular incompatibility occurs between the FHL and fibro-osseous tunnel.…”

Section: Discussionmentioning

confidence: 99%

“…When the ankle is excessively plantar flexed, angular incompatibility occurs between the FHL and fibro-osseous tunnel. The FHL tendon can be subjected to abnormal stress during an ankle sprain in excessive plantar flexion, and tenosynovitis may develop [4]. The fact that all patients except 160…”

Section: Discussionmentioning

confidence: 99%

“…In another study, it was reported that PAA should be the accepted standard in the treatment of pathologies related to the feet due to the low complication rate and faster recovery time [27]. In one study, in the 1-year follow-up of patients whose OT excision and massive effusion around FHL were treated with synovectomy and whose tendon sheath excision was treated with PAA, massive effusion did not reoccur [4]. In the present study, the amount of effusion detected through the MRI before PAA was reduced by at least one degree, and in six patients, it completely disappeared.…”

Section: Discussionmentioning

confidence: 99%

“…In the presence of OT, the FHL tendon sheath is compressed and narrowed, and stenosing tenosynovitis develops [1]. The effusion seen in the magnetic resonance imaging (MRI) around the FHL often develops due to stenosing tenosynovitis developing in the fibroosseous tunnel region [4].…”

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confidence: 99%

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Clinical and radiological results of posterior ankle endoscopy treatment for the flexor hallusis longus tenosynovitis and os trigonum syndrome

Saylık

2023

The European Research Journal

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Objectives: This study investigated the effect of two portal posterior ankle arthroscopy (PAA) procedures using American Orthopaedic Foot and Ankle Society (AOFAS) and Visual Analog Scale (VAS) scores for the treatment of patients with ankle pain associated with Os trigonum (OT) and Flexor hallusis longus (FHL) tenosynovitis. The effect of PAA treatment on the degree and localization of effusion around the FHL tendon was also investigated. Methods: Between March 2016 and August 2021, 41 patients who underwent PAA with the diagnosis of OT and stenosing FHL tenosynovitis, whose arthroscopy video records could be reviewed retrospectively, and who had at least 1 year of follow-up results were included in the study. Patients in the pediatric age group, diabetes patients, patients with inflammatory disease, and those with subtalar and tibiotalar osteoarthritis were excluded from the study. Preoperative and postoperative physical examinations, lateral radiography of the pressing foot, MRI, and the VAS and AOFAS scores were evaluated. In the statistical analysis, data were statistically analyzed using SPSS 19.0 (SPSS, Chicago, Illinois, USA). p < 0.05 was accepted as statistically significant. Results: The mean age was 35.6 years (range: 19-55), among which the mean age of the women was 36.2 years (range: 24-48), and the mean age of the men was 35.2 years (range: 19-55). The mean follow-up was 34 months (range: 14-62). The AOFAS value increased from 38.61 ± 7.176 preoperatively to 89.83 ± 6.34 at the postoperative follow-up, and the difference was statistically significant (p < 0.001). Five patients fully regained their normal function (AOFAS score = 100 points). The VAS value increased from 90 ± 5.916 preoperatively to 18.682 ± 7.688 at the last postoperative follow-up, and the difference was statistically significant (p < 0.001). Pre-PAA FHL tenosynovitis was seen only in zone 1 in 26 patients, zones 1 and 2 in 14 patients, and in zones 1, 2, and 3 in two patients. There was no significant decrease in effusion in the magnetic resonance imaging (MRI) at 1 month after the PAA (p = 0.117). A significant decrease in effusion was observed in the MRI taken at the last control (p < 0.001). Conclusions: In the treatment of patients with ankle pain associated with OT and FHL tenosynovitis, the two-portal PAA treatment was observed to be an effective method that resulted in significant improvement in the AOFAS and VAS scores.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Clinical and radiological results of posterior ankle endoscopy treatment for the flexor hallusis longus tenosynovitis and os trigonum syndrome

Saylık

2023

The European Research Journal

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“…The patient was asymptomatic and able to resume activities of daily living 1 week postoperatively. 71 Additionally, in a study evaluating the surgical technique and outcomes of all-inside arthroscopic treatment of FHL tendon impingement syndrome, Feng and colleagues 21 found meaningful advantages. These included small surgical trauma, fast functional recovery, and reliable outcomes with an average AOFAS score increase to 97 postoperatively (with all cases rated excellent or good).…”

Section: Specific Pathology Presentation and Treatmentmentioning

confidence: 99%