Anatomical Reconstruction of the Spring Ligament Using Peroneus Longus Tendon Graft

2003 ◽  
Vol 24 (5) ◽  
pp. 430-436 ◽  
Author(s):  
Kyungjin Choi ◽  
Samuel Lee ◽  
James C. Otis ◽  
Jonathan T. Deland
Keyword(s):  
Tendon Graft ◽  
Anatomical Reconstruction ◽  
Posterior Tibial Tendon ◽  
Soft Tissue Reconstruction ◽  
Peroneus Longus Tendon ◽  
Lateral Column ◽  
Longus Tendon ◽  
Peroneus Longus ◽  
Spring Ligament ◽  
Tissue Reconstruction

Posterior tibial tendon insufficiency is often associated with failure of the spring ligament and flatfoot deformity. Arch correction procedures involving bony realignment, such as lateral column lengthening or joint fusions, can predispose to arthritis. Soft tissue reconstruction may provide a more anatomical correction without these complications. The purpose of this investigation was to compare the ability of three different spring ligament reconstruction procedures to correct flatfoot deformity. A deformity model of 5°–15° talonavicular abduction was created in 10 cadaver foot-ankle specimens. Three reconstructions utilizing the peroneus longus tendon were evaluated for their ability to correct talonavicular abduction and subtalar eversion under 357 N vertical GRF load. A superomedial/plantar passage of the tendon through the calcaneus and navicular was shown to be more effective than either of the other two approaches, correcting the talonavicular joint from 9.1° ± 8.1° abducted to 1.0° ± 6.8° adducted, and the subtalar joint from 3.1° ± 3.3° everted to 0.4° ± 4.2° inverted. Thus, an anatomical reconstruction of a model of a failed spring ligament was demonstrated to be effective in the correction of a flatfoot deformity produced in cadaver foot–ankle specimens.

scholarly journals Arthroscopic anterior cruciate ligament reconstruction with semitendinosus graft versus peroneus longus tendon graft

2020 ◽  
Vol 6 (2) ◽  
pp. 386
Author(s):  
Pudari Manoj Kumar ◽  
Ishan Shevte ◽  
Mukesh Phalak ◽  
Abhishek Nair ◽  
Parth .
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Tendon Graft ◽  
Collateral Ligament ◽  
Peroneus Longus Tendon ◽  
Longus Tendon ◽  
Peroneus Longus ◽  
Anterior Cruciate ◽  
Tendon Autograft

<p class="abstract"><strong>Background:</strong> Arthroscopic anterior cruciate ligament (ACL) reconstruction can be performed using autograft from various sources namely, bone patellar tendon graft, hamstring tendons (semitendinosus, gracilis) or peroneus longus tendon.</p><p class="abstract"><strong>Methods:</strong> A prospective study of 30 patients who underwent arthroscopic ACL reconstruction using quadrupled semitendinosus tendon autograft and peroneus longus tendon autograft during the study period.<strong></strong></p><p class="abstract"><strong>Results:</strong> Statistically, there is very little comparable difference between semitendinosus and peroneus longus when used for arthroscopic ACL reconstruction. However, peroneus longus tendon shows superior results when used in patients with grade 3 medial collateral ligament (MCL) injury combined with ACL injury.</p><p class="abstract"><strong>Conclusions:</strong> Our study brings forth the superior efficacy and quality of the double stranded peroneus longus tendon especially in cases associated with complicated injuries involving the medial collateral ligament with a follow up date of about 2 years and as a healthy supplement to other choices of autografts and revision cases.</p>

Evaluation of Donor Ankle Function after Harvesting Peroneus Longus Tendon Graft for Anterior Cruciate Ligament Reconstruction- A Prospective Cohort Study

2021 ◽  
Author(s):  
Mamata Manjari Sahu ◽  
Arul S Pragassame ◽  
Patitapaban Mohanty ◽  
Pabitra Kumar Sahoo
Keyword(s):  
Cruciate Ligament ◽  
Tendon Graft ◽  
P Value ◽  
Foot And Ankle ◽  
Peroneus Longus Tendon ◽  
Longus Tendon ◽  
Peroneus Longus ◽  
Anterior Cruciate ◽  
Ankle Function

Introduction: Primary full thickness Peroneus Longus Tendon Graft (PLTG) for Anterior Cruciate Ligament Reconstruction (ACLR) has been used with good clinical outcome. Recently, it is designated as a promising graft option for ACLR. The effect of harvesting PLTG on donor ankle function is still not completely understood. Peroneus Longus Tendon (PLT) is thought to play a major role in proprioceptive regulation of the ankle joint. All the studies till date did cross-sectional assessments of ankle and foot function at or after 6 months that might have overlooked the timely detection of donor site morbidities. Aim: To evaluate the ankle function and compare the affected and sound limb function in subjects with an ACLR with autologous PLTG starting at an early postoperative visit upto six months. Materials and Methods: A prospective cohort study was conducted at a tertiary rehabilitation centre from March 2019 to March 2021 including the follow-up evaluation. As per the inclusion criteria, 63 participants after ACLR with PLTG were considered for assessment using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hind foot scale and Foot and Ankle Ability Measure (FAAM) scale at 6 weeks, 3 months and 6 months post-ACLR follow-up. Comparison between sound and affected limbs was done during all follow-ups. The statistical analysis was done using Statistical Package for the Social Sciences (SPSS) version 18.0. Both FAAM and AOFAS ankle and foot scores were analysed with non parametric tests. Results: Mean age of 63 participants were 29.25 years. Median of AOFAS and FAAM score at 6 week, 3 month, and 6 month post- ACLR follow-ups were (88, 98 and 100) and (97.22, 98.80 and 100), respectively. Statistically significant increase in AOFAS and FAAM scores were observed at 3 month and 6 month as compared to 6 week follow-ups with p=0.001 and p-value=0.001 respectively. The group comparison between the affected and sound side functional scores at different study visits showed statistically significant greater values for the sound ankle than the affected ankle (FAAM: 6 week: p-value=0.001; 3 month: p-value=0.001; 6 month: p-value=0.001 and AOFAS p-value=0.001; p-value=0.001; p-value=0.001, respectively). Conclusion: The evaluation of functional outcomes showed gradual and linear improvement at subsequent postoperative visits and restores fully to 100% at 6 month indicating a near- normal to normal donor ankle function following ACLR with PLTG by 6 months. The group comparison showed only marginal but significant difference between affected and sound ankle function.

Indications for Deltoid and Spring Ligament Reconstruction in Progressive Collapsing Foot Deformity

2020 ◽  
Vol 41 (10) ◽  
pp. 1302-1306
Author(s):  
Jonathan T. Deland ◽  
Scott J. Ellis ◽  
Jonathan Day ◽  
Cesar de Cesar Netto ◽  
Beat Hintermann ◽  
...  
Keyword(s):  
Ligament Reconstruction ◽  
Joint Space ◽  
Valgus Deformity ◽  
Deltoid Ligament ◽  
Soft Tissue Reconstruction ◽  
Foot Deformity ◽  
Level Of Evidence ◽  
Lateral Column ◽  
Spring Ligament ◽  
Tissue Reconstruction

Recommendation: There is evidence supporting medial soft tissue reconstruction, such as spring and deltoid ligament reconstructions, in the treatment of severe progressive collapsing foot deformity (PCFD). We recommend spring ligament reconstruction to be considered in addition to lateral column lengthening or subtalar fusion at the initial operation when those procedures have given at least 50% correction but inadequate correction of the severe flexible subluxation of the talonavicular and subtalar joints. We also recommend combined flatfoot reconstruction and deltoid reconstruction be considered as a joint sparing alternative in the presence of PCFD with valgus deformity of the ankle joint if there is 50% or more of the lateral joint space remaining. Level of Evidence: Level V, expert opinion.

Peroneus Longus Tendon Autograft: A Promising Graft for ACL Reconstruction

2021 ◽  
Vol 1 (4) ◽  
pp. 263502542110098
Author(s):  
Nicolaas C. Budhiparama ◽  
Sholahuddin Rhatomy ◽  
Krisna Yuarno Phatama ◽  
William Chandra ◽  
Asep Santoso ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Donor Site ◽  
Hamstring Tendon ◽  
Tendon Graft ◽  
Skin Incision ◽  
Peroneus Longus Tendon ◽  
Longus Tendon ◽  
Peroneus Longus ◽  
Tendon Autograft ◽  
Primary Acl Reconstruction

Background: With the increasing use of hamstring tendon as an autograft in anterior cruciate ligament (ACL) reconstruction, some shortcomings have been found on the donor site. Therefore, an alternative autograft option with adequate strength and less donor site morbidity will be very valuable. Peroneus longus tendon has been found to be a promising option. Indication: Primary ACL reconstruction. Technique Description: Peroneus longus tendon graft is harvested with a longitudinal skin incision at 2 to 3 cm (2 finger-breadths) above and 1 cm (1 finger-breadth) behind the lateral malleolus, followed by superficial fascia incision in line with skin incision. The peroneus longus and peroneus brevis tendons were then identified. The tendon division location was marked at 2 to 3 cm above the level of the lateral malleolus. After that, an end-to-side suture was performed between the distal part of the peroneus longus tendon and peroneus brevis tendon. The peroneus longus tendon was stripped proximally with a tendon stripper to at least 5 cm from the fibular head to prevent peroneal nerve injury. Graft preparation was performed with a standard procedure to obtain the suitable graft size. In routine arthroscopic ACL reconstruction, peroneus longus tendon graft fixation can be performed with a cortical suspension device, bioabsorbable screws, or a combined technique. Results: Recent studies showed that peroneus longus autograft had a comparable outcome with hamstring tendon autograft in primary ACL reconstruction at a 1-year follow-up. The use of peroneus longus tendon autograft resulted in larger graft diameter and less thigh hypotrophy. The mean (±SD) for the AOFAS-Hindfoot Score in the peroneus longus group was 97.3 ± 4.2, while the mean FADI score was 98 ± 3.4, both of which were considered excellent results. Discussion/Conclusion: The use of peroneus longus autograft in primary ACL reconstruction is a safe procedure with an excellent outcome. Peroneus longus tendon autograft can be recommended as an alternative graft in single-bundle ACL reconstruction. Further study of the functional outcome and knee stability evaluation is recommended.

scholarly journals Anterior Half of the Peroneus Longus Tendon Combined with Semitendinosus and Gracilis Tendons for Anterior Cruciate Ligament Reconstruction: An Athlete Case Report

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Diego Escudeiro de Oliveira ◽  
Melanie Mayumi Horita ◽  
Marconde de Oliveira e Silva ◽  
Victor Eduardo Roman Salas ◽  
Pedro Baches Jorge
Keyword(s):  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Hamstring Tendon ◽  
Tendon Graft ◽  
Hamstring Tendon Graft ◽  
Peroneus Longus Tendon ◽  
Longus Tendon ◽  
Peroneus Longus ◽  
Anterior Half ◽  
Anterior Cruciate

In clinical practice, it is observed that the hamstring tendon graft, despite being first choice in knee ligament reconstruction, may not present adequate size. Therefore, it becomes necessary to search for other graft alternatives. In this context, the peroneus longus tendon arises as an option to replace or complement other grafts. The surgeon can opt to use the tendon in its totality or only its anterior half, presenting adequate length, diameter, and biomechanics, without major repercussions for the donor site. In this study, we report a case of an athlete in which the autologous hamstring tendon graft did not present the adequate diameter for anterior cruciate ligament reconstruction. It was, then, necessary to use the anterior half of the peroneus longus tendon.

Osteolysis of Structural Autograft after Calcaneocuboid Distraction Arthrodesis for Stage II Posterior Tibial Tendon Dysfunction

2002 ◽  
Vol 23 (6) ◽  
pp. 521-529 ◽  
Author(s):  
Stephen F. Conti ◽  
Yue Shuen Wong
Keyword(s):  
Structural Integrity ◽  
Nonoperative Treatment ◽  
Stage Ii ◽  
Posterior Tibial Tendon ◽  
Soft Tissue Reconstruction ◽  
Posterior Tibial Tendon Dysfunction ◽  
Lateral Column ◽  
Posterior Tibial ◽  
Tendon Lengthening ◽  
Tissue Reconstruction

Surgical treatment of stage II posterior tibial tendon dysfunction that fails nonoperative treatment is amenable to operative treatment. This commonly consists of a medial soft-tissue reconstruction and lateral column lengthening. We report on 32 patients undergoing distraction calcaneocuboid arthrodesis using an autogenous tricortical iliac crest graft. Almost 50% of patients did not go on to complete and uneventful incorporation of the graft at the arthrodesis site. Two different types of failure were noted. The first was classic nonunion which maintained structural integrity of the graft. The second was osteolysis and collapse of the graft accompanying the nonunion. Risk factors included smoking, K-wire fixation and possibly larger deformities requiring Achilles tendon lengthening. Complications of nonunion were salvageable with reoperation.

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