Tendoscopic peroneal retinaculum repair for recurrent peroneal tendon dislocation enables earlier return to sports than the open procedure

Abstract

Purpose The purpose of this study was to evaluate whether tendoscopic peroneal retinaculum repair for patients with recurrent peroneal tendon dislocation (RPTD) is more useful than an open procedure. Methods Twenty-five patients with RPTD were retrospectively reviewed. Twelve patients (13 ankles) with RPTD underwent the open procedure (Group A) between 2008 and 2014, and 13 patients (14 ankles) underwent the tendoscopic procedure (Group B) between 2014 and 2017. Evaluation parameters included clinical results [the Japanese Society for Surgery of the Foot (JSSF) ankle-hind foot scale], operation time, complications, return to sports, and recurrence. Results Postoperative JSSF ankle/hindfoot scale scores were significantly better than the pre-surgical scores in both groups. The mean operation time was significantly longer in Group B than in Group A (75.7 ± 20.5 vs 38.4 ± 10.5 min). There was one recurrence in Group A, but none in Group B. Group A had no complications, and Group B had one wound infection. Group B, excluding the case of infection, could return to sports earlier than Group A, excluding the recurrent case (13.4 ± 1.5 vs 12.2 ± 0.6 weeks). Conclusions This tendoscopic procedure needs longer operation time and is more technically demanding, but it is a useful procedure, because it is less invasive and can accelerate return to sports. Level of evidence III.

Knotless Tendoscopic Peroneal Retinaculum Repair Technique for Recurrent Peroneal Tendon Dislocation

“…9 A similar procedure to tendoscopic surgery for RPTD was reported to enable earlier return to sports activity than in open procedure. 10 Moreover, peroneal tendons have some variations and abnormalities, such as low-lying peroneal brevis muscle belly, peroneus quartus, tenosynovitis, and longitudinal tear of the peroneal brevis muscle belly. Furthermore, RPTDs often occur combined with these variations and abnormalities.…”

In-Office Needle Tendoscopy of the Peroneal Tendons

“…There is a small but growing body of evidence that tendoscopic treatment of peroneal disorders are associated with improved outcomes and quicker recovery compared to their traditional open counterparts. 6 We do recommend keeping in mind the advantages, disadvantages and potential downsides when considering needle arthroscopy for a patient ( Tables 2 and 3 ).…”

“…2,3 Consequently, there has been a recent trend toward the use of peroneal tendoscopy as a less-invasive treatment that may improve outcomes compared to traditional open management of peroneal disorders. [4][5][6][7] Although peroneal tendoscopy was traditionally performed in the operating room with the patient under general or regional anesthesia with sedation, this technique is particularly amenable to in-office needle tendoscopy (IONT) for several reasons. IONT allows for dynamic assessment of peroneal tendon instability and live visualization of peroneal tendon sliding within the sheath and groove.…”

“… 2 , 3 Consequently, there has been a recent trend toward the use of peroneal tendoscopy as a less-invasive treatment that may improve outcomes compared to traditional open management of peroneal disorders. 4 , 5 , 6 , 7 …”

Tendoscopic Surgery for Peroneal Tendons Instability: A Literature Review

“…In one study (Guillo S, Calder JD), one patient had skin irritation caused by the anchor suture under the skin requiring removal of suture after 3 months [14]. In another study (Nishimura et al), one patient with history of atopic dermatitis had skin stitch infection that resolved after stitch removal [19]. In Guelfi et al study, one patient had pain for 12 months after peroneal groove deepening.…”