Tendoscopic peroneal retinaculum repair for recurrent peroneal tendon dislocation enables earlier return to sports than
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Tendoscopic peroneal retinaculum repair for recurrent peroneal tendon dislocation enables earlier return to sports than the open procedure Akinobu Nishimura1,2 · Ko Kato3 · Shigeto Nakazora3 · Yoshiyuki Senga1 · Aki Fukuda3 · Akihiro Sudo1,2 Received: 1 July 2019 / Accepted: 22 January 2020 © European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2020
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. Keywords Peroneal tendon dislocation · Tendoscope · Return to sports · Retinaculum repair
Introduction Peroneal tendon dislocation (PTD) is a relatively rare sport injury that occurs in 0.3–0.5% of all traumatic ankle events, mostly in sports that require cutting movements [25]. PTD is often misdiagnosed as an ankle sprain [11, 16]. Since conservative treatment is associated with a high failure rate (50–76%) [5, 6], many PTDs lead to recurrent PTD (RPTD). * Akinobu Nishimura [email protected]‑u.ac.jp 1
Departments of Orthopaedic Surgery, Mie University Graduate School of Medicine, 2‑174 Edobashi, Tsu, Mie 514‑8507, Japan
2
Orthopaedic and Sports Medicine, Mie University Graduate School of Medicine, 2‑174 Edobashi, Tsu, Mie 514‑8507, Japan
3
Department of Orthopaedic Surgery, Suzuka Kaisei Hospital, 112‑2 Kou‑cho, Suzuka, Mie 513‑0809, Japan
RPTD can cause chronic pain or a sense of instability [23], so surgical treatment is often indicated for patients, especially young, active people and athletes [32]. Numerous operative techniques have been reported so far. Surgical procedures have been divided into three main categories [29]: (1) repair or replacement of the superior peroneal retinaculum (SPR) [1, 4]; (2) groove deepening of the retromalleol
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