Mid-substance peroneal tendon defects augmented with an acellular dermal matrix allograft

Area of Science:

• Orthopedic Surgery
• Regenerative Medicine
• Sports Medicine

Background:

• Chronic tears of the peroneus longus and brevis tendons often involve significant tissue loss.
• Traditional repair methods may be limited by the quality and quantity of remaining tendon tissue.

Purpose of the Study:

• To evaluate the efficacy of acellular dermal matrix (ADM) allograft augmentation for chronic mid-substance peroneal tendon tears.
• To determine if ADM augmentation provides sufficient initial strength for a rapid rehabilitation program.

Main Methods:

• Prospective evaluation of 11 patients with mid-substance peroneal tendon tears and tissue loss.
• Surgical technique included direct tendon repair, fibular sulcus deepening, and ADM "gap jumping" tubular grafting.
• Patients followed a rapid rehabilitation protocol post-surgery.

Main Results:

• All patients demonstrated successful augmentation with ADM, with a mean postoperative American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score of 93.5.
• All patients achieved functional recovery, including single-heel rise, painless range of motion, and symmetrical eversion/inversion strength.
• No postoperative hindfoot varus deformity was observed.

Conclusions:

• Acellular dermal matrix allograft is an effective "gap jumping" augmentation for chronic degenerative peroneal tendon tear repairs.
• This technique facilitates a robust repair, allowing for accelerated patient rehabilitation and functional recovery.