scholarly journals A false-pouch closure technique with an intact superior peroneal retinaculum for recurrent dislocation of the peroneal tendon

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Tomohiro Matsui ◽  
Tsukasa Kumai ◽  
Yasushi Shinohara ◽  
Noriyuki Kanzaki ◽  
Koji Noguchi ◽  
...  
Keyword(s):  
Case Series ◽  
Recurrent Dislocation ◽  
Return To Sports ◽  
Peroneal Tendon ◽  
Closure Technique ◽  
Level Of Evidence ◽  
Sports Activity ◽  
Early Return ◽  
The Mean ◽  
American Orthopaedic

Abstract Purpose To evaluate the usefulness of the false-pouch closure technique with an intact superior peroneal retinaculum (SPR). Methods From 2016 to 2020, 30 patients with recurrent dislocation of the peroneal tendon were treated with the current procedure. Clinical outcomes, including the time to resume running, the rate and time to return to sports, and the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hind Foot score, were evaluated preoperatively and at the last follow-up. Results The rate of return to the pre-injury level of sports activity was 93.3%, and the mean duration to return to running and sports was 8.0 ± 2.8 weeks (range: 3–12 weeks) and 14.4 ± 3.2 weeks (range: 10–24 weeks), respectively. The mean preoperative AOFAS score was 79.7 ± 9.6 points (range: 41–90), which improved significantly to 98.9 ± 3.2 (87–100) postoperatively (p < 0.01). Conclusion The false-pouch closure technique with suture tape and anchors had a reliable clinical outcome and can enable the early return of patients to their sports activities. Level of evidence IV, Case series

Tendoscopic Treatment of Peroneal Intrasheath Subluxation: A New Subgroup With Superior Peroneal Retinaculum Injury

2018 ◽  
Vol 39 (5) ◽  
pp. 542-550 ◽  
Author(s):  
Matteo Guelfi ◽  
Jordi Vega ◽  
Francesc Malagelada ◽  
Albert Baduell ◽  
Miki Dalmau-Pastor
Keyword(s):  
Clinical Signs ◽  
Case Series ◽  
Peroneal Tendon ◽  
Level Of Evidence ◽  
Lateral Ankle ◽  
Peroneal Tendons ◽  
The Mean ◽  
American Orthopaedic ◽  
Space Occupying Lesion

Background: Snapping peroneal tendons is a rare cause of lateral ankle pain. Two subgroups have been described: chronic subluxation with superior peroneal retinaculum (SPR) injury and intrasheath subluxation with SPR intact. The aim of the study was to report the tendoscopic findings and results in patients affected by snapping peroneal tendons without evident dislocation. Methods: Between 2010 and 2015, a total of 18 patients with a retromalleolar “click” sensation and no clinical signs of peroneal tendon dislocation underwent tendoscopy. Mean age was 29 years (range, 18-47). Mean follow-up was 45 months (range, 18-72). Results: Tendoscopic examination revealed an intact SPR in 12 patients. Of these 12, a space-occupying lesion was present in 7, a superficial tear of peroneus brevis in 4, and a shallow fibular groove in 7. An SPR injury without peroneal tendon dislocation was observed in the remaining 6 patients. All these 6 patients presented a shallow fibular groove. Although the SPR was injured, they had been diagnosed as intrasheath subluxation. Patients with intrasheath subluxation and intact SPR underwent debridement of a space-occupying lesion in 11 cases and fibular groove deepening in 5 cases. Patients with intrasheath subluxation and SPR injury underwent fibular groove deepening without addressing the SPR. At follow-up, the mean American Orthopaedic Foot & Ankle Society score increased from 76 (range, 69-85) preoperatively to 97 (range, 84-100). No recurrence or major complications were reported. Conclusion Intrasheath subluxation of peroneal tendons was successfully treated tendoscopically. A new subgroup of intrasheath subluxation with SPR injury but no clinically evident peroneal tendon dislocation is reported. Level of Evidence: Level IV, case series.

Return to Sports and Activity After Total Ankle Arthroplasty and Arthrodesis: A Systematic Review

2020 ◽  
Vol 41 (8) ◽  
pp. 916-929 ◽  
Author(s):  
William L. Johns ◽  
Christopher B. Sowers ◽  
Kempland C. Walley ◽  
Daniel Ross ◽  
David B. Thordarson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Participation Rate ◽  
Sports Participation ◽  
Operative Management ◽  
Cochrane Library ◽  
Activity Participation ◽  
Return To Sports ◽  
Level Of Evidence ◽  
Sports Activity ◽  
The Mean

Background: There is no consensus regarding participation in sports and recreational activities following total ankle replacement (TAR) and ankle arthrodesis (AA). This systematic review summarizes the evidence on return to sports and activity after operative management with either TAR or AA for ankle osteoarthritis (OA). Methods: A literature search of MEDLINE, EMBASE, CINAHL, and Cochrane Library databases was performed. Risk of bias of included studies was assessed using Methodological Index for Non-Randomized Studies (MINORS) criteria. Included studies reported sport and activity outcomes in patients undergoing TAR and AA, with primary outcomes being the percentage of sports participation and level of sports participation. Results: Twelve studies met inclusion criteria for analysis. There were 1270 ankle procedures, of which 923 TAR and 347 AA were performed. The mean reported patient age was 59.2 years and the mean BMI was 28 kg/m2. The mean follow-up was 43 months. Fifty-four percent of patients were active in sports preoperatively compared with 63.7% postoperatively. The mean preoperative activity participation rate was 41% in the TAR cohort, but it improved to 59% after TAR, whereas the preoperative activity participation rate of 73% was similar to the postoperative rate of 70% in the AA cohort. The most common sports in the TAR and AA groups were swimming, hiking, cycling, and skiing. Conclusion: Participation in sports activity was nearly 10% improved after operative management of ankle OA with TAR and remains high after AA. The existing literature demonstrated a large improvement in pre- to postoperative activity levels after TAR, with minimal change in activity after AA; however, AA patients were more active at baseline. The most frequent postoperative sports activities after operative management of ankle OA were swimming, hiking, cycling, and skiing. Participation in high-impact sports such as tennis, soccer, and running was consistently limited after surgery. This review of the literature will allow patients and foot and ankle surgeons to set evidence-based goals and establish realistic expectations for postoperative physical activity after TAR and AA. Level of Evidence: Level III, systematic review.

Lateral Transfer of the Flexor Digitorum Longus for Peroneal Tendinopathy

2019 ◽  
Vol 40 (9) ◽  
pp. 1012-1017 ◽  
Author(s):  
Thomas I. Sherman ◽  
Kimberly Koury ◽  
Jakrapong Orapin ◽  
Lew C. Schon
Keyword(s):  
Average Power ◽  
Case Series ◽  
Peroneal Tendon ◽  
Flexor Digitorum Longus ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Function Index ◽  
The Mean ◽  
Flexor Digitorum

Background: Few studies have reported midterm outcomes after single-stage flexor digitorum longus (FDL) tendon transfer to the lateral foot for irreparable rupture of the peroneal tendons. Methods: Over a 7-year period (2008-2015), 25 consecutive patients underwent transfer of the FDL to the fifth metatarsal for irreparable peroneal tendon tears. Of these, 15 patients were available for inclusion with a mean follow-up of 53.7 ± 23.3 months, mean age at surgery of 48.4 years, and mean body mass index (BMI) of 29.8 kg/m2. Patients completed the pain visual analog scale (VAS), Foot Function Index (FFI), Short Musculoskeletal Function Assessment (SMFA), and Foot and Ankle Ability Measure (FAAM) and participated in range of motion, peak force, and peak power testing. Results: All 15 patients were satisfied with their surgery and reported a reduction in their pain level with a decreased VAS of 5.6 ± 2.5. The mean FFI was 12.8 ± 9.2, the SMFA Function Index was 12.4 ± 8, and the mean SMFA Bothersome Index was 11.5 ± 11. The mean FAAM was 86.4 ± 9.7. Patients had on average 58% less eversion and 28% less inversion compared with the nonoperative side. Isometric peak torque and isotonic peak velocity were 38.4% and 28.8% less compared with the contralateral side, respectively. The average power in the operative limb was diminished by 56% compared with the nonoperative limb. Conclusion: In this small case series with midterm follow-up, FDL transfer to the lateral foot for significant, irreparable peroneal tendinopathy was an effective and durable treatment option. Level of Evidence: Level IV, retrospective case series.

scholarly journals Surgical treatment of hallux valgus using a modified Reverdin-Isham technique

2021 ◽  
Vol 15 (1) ◽  
pp. 49-53
Author(s):  
Luiz Lara ◽  
Lúcio Torres Filho ◽  
Gabriel Cervone ◽  
Juan Grajales ◽  
Glaucia Bordignon ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Hallux Valgus ◽  
Case Series ◽  
Metatarsal Head ◽  
Level Of Evidence ◽  
Valgus Angle ◽  
Significant Correction ◽  
The Mean ◽  
American Orthopaedic

Objective: To evaluate the postoperative results of patients who underwent surgical treatment of hallux valgus with a modified Reverdin-Isham (RI) technique and to compare the achieved correction with that reported by studies using the original technique. Methods: This is a retrospective study with patients with mild to moderate hallux valgus who underwent surgery from June 2010 to July 2019. All patients were operated using the modified RI technique. Data were collected through the American Orthopaedic Foot and Ankle Society (AOFAS) questionnaire, in addition to pre and postoperative radiographic studies of the intermetatarsal angle (IMA), the hallux valgus angle (HVA), and the distal metatarsal articular angle (DMAA). Results: The mean postoperative follow-up was 30.1 months, and the mean age of patients was 56.4 years. The median AOFAS score in the postoperative period was increased by 56 points. The mean HVA was reduced in 16.5°, the mean IMA was reduced in 4.3°, and the mean DMAA was reduced in 10°. There were no cases of displacement or deviation of the first metatarsal head during the postoperative follow-up. Conclusion: The modified RI technique provided considerable stability to the osteotomy, in addition to a significant correction of the measured angles and an improvement in AOFAS scores, demonstrating itself as an effective technique for correcting mild to moderate hallux valgus. Level of Evidence IV, Therapeutic Studies, Case Series.

scholarly journals Ultrasonographic Evaluation of the Early Healing Process After Achilles Tendon Repair

2018 ◽  
Vol 6 (8) ◽  
pp. 232596711878988 ◽  
Author(s):  
Kunihiko Hiramatsu ◽  
Akira Tsujii ◽  
Norimasa Nakamura ◽  
Tomoki Mitsuoka
Keyword(s):  
Achilles Tendon ◽  
Primary Repair ◽  
Healing Process ◽  
Tendon Repair ◽  
Case Series ◽  
Return To Sports ◽  
Level Of Evidence ◽  
Unaffected Side ◽  
The Mean ◽  
Early Healing

Background: Little is known about early healing of repaired Achilles tendons on imaging, particularly up to 6 months postoperatively, when patients generally return to participation in sports. Purpose: To examine changes in repaired Achilles tendon healing with ultrasonography for up to 12 months after surgery. Study Design: Case series; Level of evidence, 4. Methods: Ultrasonographic images of 26 ruptured Achilles tendons were analyzed at 1, 2, 3, 4, 6, and 12 months after primary repair. The cross-sectional areas (CSAs) and intratendinous morphology of the repaired tendons were evaluated using the authors’ own grading system (tendon repair scores), which assessed the anechoic tendon defect area, intratendinous hyperechoic area, continuity of intratendinous fibrillar appearance, and paratendinous edema. Results: The mean ratios (%) of the CSA for the affected versus unaffected side of repaired Achilles tendons gradually increased postoperatively, reached a maximum (632%) at 6 months, and then decreased at 12 months. The mean tendon repair scores increased over time and reached a plateau at 6 months. Conclusion: Ultrasonography is useful to observe the intratendinous morphology of repaired Achilles tendons and to provide useful information for patients who wish to return to sports. Clinical parameters such as strength, functional performance, and quality of healed repaired tendons should also be assessed before allowing patients to return to sports.

Endoscopic Flexor Hallucis Longus Transfer for Achilles Noninsertional Tendinopathy: Description of Surgical Technique and Functional Outcomes

2020 ◽  
pp. 193864001989591
Author(s):  
Juan Bernardo Gerstner G ◽  
Ian Winson ◽  
Jimmy Campo ◽  
Michael Swords ◽  
Juan Camilo Medina ◽  
...  
Keyword(s):  
Functional Outcomes ◽  
Case Series ◽  
Functional Results ◽  
Achilles Tendinopathy ◽  
Flexor Hallucis Longus ◽  
Aofas Score ◽  
Level Of Evidence ◽  
Flexor Hallucis Longus Transfer ◽  
The Mean ◽  
American Orthopaedic

Background. The transfer of the flexor hallucis longus (FHL) tendon is an established treatment for replacing a dysfunctional Achilles tendon. Objectives. (1) Describe a new technique for endoscopic FHL transfer for noninsertional Achilles tendinopathy and (2) describe the functional outcomes and complications after endoscopic and open FHL transfer. Materials and Method. Retrospective study of patients who underwent open or endoscopic FHL transfer between 2014 and 2016. The American Orthopaedic Foot & Ankle Society (AOFAS) ankle/hindfoot scale was used preoperatively and postoperatively to measure the functional results. Results. We included 18 endoscopic FHL transfers and 24 open FHL transfers. The mean age of endoscopic and open procedures was 47.5 years (range 25-77 years) and 61.2 years (range 43-72 years), respectively. An improvement on the average AOFAS of 52.8% (31.9 points) was observed in the endoscopy group during the follow-up from the baseline. The mean improvement in AOFAS score for the open group was 41.4% (24.5 points). Four and 7 cases reported complications in the endoscopy and open FHL transfer groups, respectively. Conclusion. While both procedures were effective in treating noninsertional Achilles tendinopathy, the described arthroscopic treatment led to a greater improvement in the AOFAS score and is slightly less prone to lasting complications. Level of Evidence: Level IV: Case series

Results of Peroneal Tendoscopy With a Technical Modification

2018 ◽  
Vol 40 (3) ◽  
pp. 356-363 ◽  
Author(s):  
Mustafa Urguden ◽  
Ismail Ayder Gulten ◽  
Osman Civan ◽  
Hakan Bilbasar ◽  
Cagri Kaptan ◽  
...  
Keyword(s):  
Case Series ◽  
Diagnosis And Treatment ◽  
Peroneal Tendon ◽  
Retrospective Case ◽  
Aofas Score ◽  
Level Of Evidence ◽  
Technical Modification ◽  
Magnetic Resonance Imaging Mri ◽  
American Orthopaedic

Background: The aim of this study was to evaluate the role of tendoscopy in the diagnosis and treatment of peroneal tendon (PT) pathologies, and to evaluate the results of our technical modification. Methods: Twenty ankles of 18 patients with retrofibular pain, operated on between 2006 and 2012, were included in this study. Peroneal tendoscopy was performed diagnostically for the patients who were diagnosed as having “peroneal tendinopathy” with physical examination, x-ray, or magnetic resonance imaging (MRI). After being diagnosed by peroneal tendoscopy, patients were definitively treated with either tendoscopy or open surgery. Results: Thirteen of 20 ankles had accompanying ankle pathology with PT pathology, and the other 7 ankles had no concomitant pathology. We detected peroneal tenosynovitis (PTS) in 13 patients, PT tear in 7 patients, and vincula thickening in 1 patient. The American Orthopaedic Foot & Ankle Society (AOFAS) score was 76 preoperatively, and after 2 years’ follow-up the AOFAS score was 96. Conclusion: Tendoscopy is a useful method for the diagnosis and treatment of PT pathologies. The patients with clinical suspicion of PT pathology were treated or diagnosed by peroneal tendoscopy with our technical modification. Level of Evidence: Level IV, retrospective case series.

scholarly journals Functional evaluation of patients undergoing endoscopic calcaneoplasty for Haglund deformity

2021 ◽  
Vol 15 (2) ◽  
pp. 155-160
Author(s):  
Hallan Douglas Bertelli ◽  
Bruno Arvatti Michelin ◽  
Isabela Ferreira Perucci ◽  
Mário Sérgio Paulillo de Cillo ◽  
Carlos Daniel Candido Castro Filho ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Functional Outcomes ◽  
Case Series ◽  
Functional Evaluation ◽  
Foot And Ankle ◽  
Level Of Evidence ◽  
The Mean ◽  
Haglund Deformity ◽  
American Orthopaedic ◽  
Preoperative Score

Objective: To analyze the functional outcomes of patients undergoing endoscopic calcaneoplasty for the treatment of Haglund deformity. Methods: This study consists of a case series of patients undergoing endoscopic calcaneoplasty. The American Orthopaedic Foot and Ankle Society ankle-hindfoot scale, was used to evaluate patients before and 12 months after the procedure, providing preoperative and postoperative scores. Results: Nineteen patients were evaluated for a total of 24 endoscopic calcaneoplasties. The American Orthopaedic Foot and Ankle Society scale provided a mean preoperative score of 31.4 and a mean postoperative score of 93.3, which shows a significantly increased score after surgery. The mean patient age was 52 years, and the youngest patient was 25 years old and the oldest patient was 73 years old. However, no significant relationship was found between age and change in the American Orthopaedic Foot and Ankle Society score. No complications were observed in the immediate or late postoperative periods. Conclusion: Arthroscopic resection is efficient in the treatment of Haglund deformity given the significant improvement in the American Orthopaedic Foot and Ankle Society score observed after the procedure. Also, no postoperative complications were seen in patients who underwent endoscopic calcaneoplasty. Level of Evidence: IV; Therapeutic Studies; Case series.

scholarly journals Peripheral talus fractures

2021 ◽  
Vol 15 (1) ◽  
pp. 26-30
Author(s):  
Marcos Sakaki ◽  
Jordanna Bergamasco ◽  
Lais Pinheiro ◽  
Caio Rosa e Silva ◽  
Kenji Missima
Keyword(s):  
Case Series ◽  
High Energy ◽  
Open Fractures ◽  
Short Term ◽  
Triple Arthrodesis ◽  
Level Of Evidence ◽  
The Mean ◽  
Secondary Hospital ◽  
American Orthopaedic ◽  
The Moment

Objective: To present the epidemiology and assess short-term clinical and radiological outcomes of peripheral talus fractures treated between 2013 and 2019 at a secondary hospital. Methods: This is a retrospective study based on a series of 21 cases of peripheral talus fractures. Out of these 21 cases, 11 underwent functional assessment using the ankle-hindfoot scale of the American Orthopaedic Foot and Ankle Society (AOFAS) and radiological assessment after a mean period of 24.5 months. Results: Regarding the epidemiology of the 21 reported cases, the mean age was 28.7 years and 76.2% of the patients were male. The left foot was affected in 71.4% of the cases, and the most frequent type of trauma was motorcycle accident (47.6%); 23.8% of the cases had open fractures. Complete peritalar dislocation occurred in 38.0% of the cases and the most common fracture was that of the lateral process of the talus, in 42.8% of the cases. Eleven patients returned for reassessment and presented a mean AOFAS score of 80.9 points. All fractures were consolidated at the moment of assessment, and one of them progressed to subtalar and talonavicular osteoarthritis, requiring triple arthrodesis. Conclusion: The peripheral fractures studied here were caused by high-energy traumas with open fractures in one-quarter of the cases and were frequently associated with other fractures. The short-term functional outcome is good but has potential for severe complications such as stiffness and persistent pain. Level of Evidence IV, Therapeutic Studies; Case Series.

Endoscopic Achilles Tendon Augmentation With Suture Anchors After Calcaneal Exostectomy in Haglund Syndrome

2018 ◽  
Vol 39 (5) ◽  
pp. 551-559 ◽  
Author(s):  
Jordi Vega ◽  
Albert Baduell ◽  
Francesc Malagelada ◽  
Jörg Allmendinger ◽  
Miki Dalmau-Pastor
Keyword(s):  
Achilles Tendon ◽  
Suture Anchor ◽  
Achilles Tendon Rupture ◽  
Case Series ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Sports Activity ◽  
Increased Risk ◽  
The Mean

Background: Haglund syndrome is a common cause of heel pain. Risk for tendon detachment after calcaneoplasty can exist. Open Achilles tendon detachment, calcaneoplasty, bursectomy, pathologic tendon-tissue debridement, and tendon reattachment of the Achilles tendon is a common surgical management of Haglund syndrome combined with insertional Achilles tendinopathy. The aim of this study was to describe the endoscopic calcaneoplasty and anchor suture augmentation of the Achilles insertional area, and the results obtained in patients with an increased risk of Achilles tendon rupture after calcaneoplasty. Methods: Between 2012 and 2015, endoscopic calcaneal ostectomy and suture anchor augmentation was performed in 12 patients. Mean age was 44.8 years (range, 35-52 years), and mean follow-up was of 33.5 months (range, 21-46 months). Results: The mean AOFAS score increased from 70 preoperatively (range, 55-85) to 92 (range, 63-100) at final follow-up. The mean VISA-A questionnaire increased from 34 preoperatively (range, 15-63) to 92 (range, 30-100) at follow-up. No major complications were reported. All patients returned to their daily activities without limitations, but 2 described complaints with sports activity. Conclusion: Endoscopic calcaneoplasty and tendon augmentation with suture anchor for the treatment of Haglund syndrome was a reproducible and safe technique that offered the advantages of the endoscopic technique. Level of Evidence: Level IV, retrospective case series.

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