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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 10/2018

Open Access 01-10-2018 | Ankle

The ESSKA-AFAS international consensus statement on peroneal tendon pathologies

Authors: Pim A. van Dijk, David Miller, James Calder, Christopher W. DiGiovanni, John G. Kennedy, Gino M. Kerkhoffs, Akos Kynsburtg, Daniel Havercamp, Stephane Guillo, Xavier M. Oliva, Chris J. Pearce, Helder Pereira, Pietro Spennacchio, Joanna M. Stephen, C. Niek van Dijk

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 10/2018

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Abstract

Introduction

Peroneal tendon injuries are a significant cause of lateral ankle symptoms in the active population. Accurate diagnosis and prompt treatment is important for minimizing the risk of long-term sequelae associated with chronic peroneal tendinopathy. Although several studies have been published on diagnostic strategies and treatment outcomes, there is no consensus on the optimal management of peroneal tendon pathologies.

Purpose

The purpose of this ESSKA-AFAS consensus statement was to conduct an international and multidisciplinary agreed guideline on management of patients with peroneal tendon pathologies.

Methods

Using the Nominal Group Technique, a panel comprised of sixteen specialists spanning nine countries was convened by the ESSKA-AFAS board. In preparation for the meeting, relevant questions were identified and supported by a systematic literature search. During the meeting, the panel members gave presentations on each question, and the evidence supporting each subject was then vetted by open discussion. Statements were thereafter adjusted on the basis of the discussion and voted upon to determine consensus using a 0–10 range Likert scale. Agreement was confirmed when a mean score of at least 7.5 was reached.

Conclusion

This ESSKA-AFAS consensus statement on the optimal management of peroneal tendon pathologies is the result of international and multidisciplinary agreement combined with a systematic review of the literature.

Level of evidence

V.
Literature
1.
Benjamin M, Qin S, Ralphs JR (1995) Fibrocartilage associated with human tendons and their pulleys. J Anat 187(Pt 3):625–633PubMedPubMedCentral
2.
Blitz NM, Nemes KK (2007) Bilateral peroneus longus tendon rupture through a bipartite os peroneum. J Foot Ankle Surg 46:270–277CrossRefPubMed
3.
Boffeli TJ, Collier RC (2012) Surgical technique for combined Dwyer calcaneal osteotomy and peroneal tendon repair for correction of peroneal tendon pathology associated with cavus foot deformity. J Foot Ankle Surg 51:135–140CrossRefPubMed
4.
Brandes CB, Smith RW (2000) Characterization of patients with primary peroneus longus tendinopathy: a review of twenty-two cases. Foot Ankle Int 21:462–468CrossRefPubMed
5.
Cerrato RA, Myerson MS (2009) Peroneal tendon tears, surgical management and its complications. Foot Ankle Clin 14:299–312CrossRefPubMed
6.
Dallaudiere B, Pesquer L, Meyer P, Silvestre A, Perozziello A, Peuchant A et al (2014) Intratendinous injection of platelet-rich plasma under US guidance to treat tendinopathy: a long-term pilot study. J Vasc Interv Radiol 25:717–723CrossRefPubMed
7.
Demetracopoulos CA, Vineyard JC, Kiesau CD, Nunley JA (2014) Long-term results of debridement and primary repair of peroneal tendon tears. Foot Ankle Int 35:252–257CrossRefPubMed
8.
DiGiovanni BF, Fraga CJ, Cohen BE, Shereff MJ (2000) Associated injuries found in chronic lateral ankle instability. Foot Ankle Int 21:809–815CrossRefPubMed
9.
Dombek MF, Lamm BM, Saltrick K, Mendicino RW, Catanzariti AR (2003) Peroneal tendon tears: a retrospective review. J Foot Ankle Surg 42:250–258CrossRefPubMed
10.
Durieux N, Vandenput S, Pasleau F (2013) [OCEBM levels of evidence system]. Rev Med Liege 68:644–649PubMed
11.
Freccero DM, Berkowitz MJ (2006) The relationship between tears of the peroneus brevis tendon and the distal extent of its muscle belly: an MRI study. Foot Ankle Int 27:236–239CrossRefPubMed
12.
Heckman DS, Reddy S, Pedowitz D, Wapner KL, Parekh SG (2008) Operative treatment for peroneal tendon disorders. J Bone Joint Surg Am 90:404–418CrossRefPubMed
13.
Helliwell TR, Tynan M, Hayward M, Klenerman L, Whitehouse G, Edwards RH (1995) The pathology of the lower leg muscles in pure forefoot pes cavus. Acta Neuropathol 89:552–559CrossRefPubMed
14.
Highlander P, Pearson KT, Burns P (2015) Magnetic resonance imaging analysis of peroneal tendon pathology associated with low-lying peroneus brevis muscle belly: a case-control study. Foot Ankle Spec 8:347–353CrossRefPubMed
15.
Hyer CF, Dawson JM, Philbin TM, Berlet GC, Lee TH (2005) The peroneal tubercle: description, classification, and relevance to peroneus longus tendon pathology. Foot Ankle Int 26:947–950CrossRefPubMed
16.
17.
Krause JO, Brodsky JW (1998) Peroneus brevis tendon tears: pathophysiology, surgical reconstruction, and clinical results. Foot Ankle Int 19:271–279CrossRefPubMed
18.
Kumai T, Benjamin M (2003) The histological structure of the malleolar groove of the fibula in man: its direct bearing on the displacement of peroneal tendons and their surgical repair. J Anat 203:257–262CrossRefPubMedPubMedCentral
19.
Le Minor JM (1987) Comparative anatomy and significance of the sesamoid bone of the peroneus longus muscle (os peroneum). J Anat 151:85–99PubMedPubMedCentral
20.
Mani-Babu S, Morrissey D, Waugh C, Screen H, Barton C (2015) The effectiveness of extracorporeal shock wave therapy in lower limb tendinopathy: a systematic review. Am J Sports Med 43:752–761CrossRefPubMed
21.
McLennan JG (1980) Treatment of acute and chronic luxations of the peroneal tendons. Am J Sports Med 8:432–436CrossRefPubMed
22.
23.
Miura K, Ishibashi Y, Tsuda E, Kusumi T, Toh S (2004) Split lesions of the peroneus brevis tendon in the Japanese population: an anatomic and histologic study of 112 cadaveric ankles. J Orthop Sci 9:291–295CrossRefPubMed
24.
Molloy R, Tisdel C (2003) Failed treatment of peroneal tendon injuries. Foot Ankle Clin 8:115–129CrossRefPubMed
25.
Pellegrini MJ, Glisson RR, Matsumoto T, Schiff A, Laver L, Easley ME et al (2016) Effectiveness of allograft reconstruction vs tenodesis for irreparable peroneus brevis tears: a cadaveric model. Foot Ankle Int 37:803–808CrossRefPubMed
26.
Purnell ML, Drummond DS, Engber WD, Breed AL (1983) Congenital dislocation of the peroneal tendons in the calcaneovalgus foot. J Bone Joint Surg Br 65:316–319CrossRefPubMed
27.
Redfern D, Myerson M (2004) The management of concomitant tears of the peroneus longus and brevis tendons. Foot Ankle Int 25:695–707CrossRefPubMed
28.
Rosenfeld P (2007) Acute and chronic peroneal tendon dislocations. Foot Ankle Clin 12:643–657, viiCrossRefPubMed
29.
Roth JA, Taylor WC, Whalen J (2010) Peroneal tendon subluxation: the other lateral ankle injury. Br J Sports Med 44:1047–1053CrossRefPubMed
30.
Sammarco VJ, Cuttica DJ, Sammarco GJ (2010) Lasso stitch with peroneal retinaculoplasty for repair of fractured os peroneum: a report of two cases. Clin Orthop Relat Res 468:1012–1017CrossRefPubMed
31.
Saupe N, Mengiardi B, Pfirrmann CW, Vienne P, Seifert B, Zanetti M (2007) Anatomic variants associated with peroneal tendon disorders: MR imaging findings in volunteers with asymptomatic ankles. Radiology 242:509–517CrossRefPubMed
32.
Saxena A, Cassidy A (2003) Peroneal tendon injuries: an evaluation of 49 tears in 41 patients. J Foot Ankle Surg 42:215–220CrossRefPubMed
33.
Seybold JD, Campbell JT, Jeng CL, Short KW, Myerson MS (2016) Outcome of lateral transfer of the FHL or FDL for concomitant peroneal tendon tears. Foot Ankle Int 37:576–581CrossRefPubMed
34.
Shibata Y, Sakuma E, Yoshida Y, Wakabayashi K, Iguchi H, Sekiya I et al (2014) Morphometric analysis of the peroneal tubercle using a three-dimensional computed tomography model. Foot (Edinb) 24:200–202CrossRef
35.
Siegel RM, Schubiner J, Sammarco VJ (2008) A nonoperative treatment technique for peroneal tendon subluxation. Clin Pediatr (Phila) 47:300–301CrossRef
36.
37.
Sobel M, Bohne WH, Levy ME (1990) Longitudinal attrition of the peroneus brevis tendon in the fibular groove: an anatomic study. Foot Ankle 11:124–128CrossRefPubMed
38.
Sobel M, Pavlov H, Geppert MJ, Thompson FM, DiCarlo EF, Davis WH (1994) Painful os peroneum syndrome: a spectrum of conditions responsible for plantar lateral foot pain. Foot Ankle Int 15:112–124CrossRefPubMed
39.
Stiell IG, McKnight RD, Greenberg GH, McDowell I, Nair RC, Wells GA et al (1994) Implementation of the Ottawa ankle rules. JAMA 271:827–832CrossRefPubMed
40.
Stockton KG, Brodsky JW (2014) Peroneus longus tears associated with pathology of the os peroneum. Foot Ankle Int 35:346–352CrossRefPubMed
41.
Strickland SM, MacGillivray JD, Warren RF (2003) Anterior cruciate ligament reconstruction with allograft tendons. Orthop Clin North Am 34:41–47CrossRefPubMed
42.
Sun J, Gao F, Wang Y, Sun W, Jiang B, Li Z (2017) Extracorporeal shock wave therapy is effective in treating chronic plantar fasciitis: A meta-analysis of RCTs. Medicine (Baltimore) 96:e6621CrossRef
43.
Taljanovic MS, Alcala JN, Gimber LH, Rieke JD, Chilvers MM, Latt LD (2015) High-resolution US and MR imaging of peroneal tendon injuries. Radiographics 35:179–199CrossRefPubMed
44.
van Dijk PA, Gianakos AL, Kerkhoffs GM, Kennedy JG (2016) Return to sports and clinical outcomes in patients treated for peroneal tendon dislocation: a systematic review. Knee Surg Sports Traumatol Arthrosc 24:1155–1164CrossRefPubMed
45.
van Dijk PA, Lubberts B, Verheul C, DiGiovanni CW, Kerkhoffs GM (2016) Rehabilitation after surgical treatment of peroneal tendon tears and ruptures. Knee Surg Sports Traumatol Arthrosc 24:1165–1174CrossRefPubMedPubMedCentral
46.
Wang XT, Rosenberg ZS, Mechlin MB, Schweitzer ME (2005) Normal variants and diseases of the peroneal tendons and superior peroneal retinaculum: MR imaging features. Radiographics 25:587–602CrossRefPubMed
47.
Yammine K (2015) The accessory peroneal (fibular) muscles: peroneus quartus and peroneus digiti quinti. A systematic review and meta-analysis. Surg Radiol Anat 37:617–627CrossRefPubMed
Metadata
Title
The ESSKA-AFAS international consensus statement on peroneal tendon pathologies
Authors
Pim A. van Dijk
David Miller
James Calder
Christopher W. DiGiovanni
John G. Kennedy
Gino M. Kerkhoffs
Akos Kynsburtg
Daniel Havercamp
Stephane Guillo
Xavier M. Oliva
Chris J. Pearce
Helder Pereira
Pietro Spennacchio
Joanna M. Stephen
C. Niek van Dijk
Publication date
01-10-2018
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 10/2018
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-018-4971-x

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