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Foot and ankle tendoscopy: evidence-based recommendations.

Chris C Cychosz¹, Phinit Phisitkul², Alexej Barg³

¹Carver College of Medicine, The University of Iowa, Iowa City, Iowa, U.S.A.

Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association

|April 15, 2014

Summary

Current evidence for foot and ankle tendoscopy is limited, with weak support for Achilles, flexor hallucis longus, and peroneal tendons. More high-quality research is needed for other tendons.

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Area of Science:

Orthopedic Surgery
Sports Medicine
Foot and Ankle Surgery

Background:

Tendoscopy is an emerging minimally invasive technique for foot and ankle pathologies.
The efficacy and indications for tendoscopy in the foot and ankle require thorough evaluation.
Evidence-based recommendations are crucial for guiding clinical practice.

Purpose of the Study:

To conduct a comprehensive literature review on foot and ankle tendoscopy.
To assign an evidence-based grade of recommendation for or against its use.
To identify gaps in the current scientific literature.

Main Methods:

Systematic literature review using PubMed, Cochrane, and Scopus databases.
Analysis of studies on foot and ankle tendoscopy, assessing their Level of Evidence (I-V).
Assignment of a grade of recommendation based on the synthesized evidence.

Main Results:

Weak evidence (grade Cf) supports tendoscopy for Achilles, flexor hallucis longus, and peroneal tendons.
Insufficient evidence (grade I) exists for tibialis posterior, tibialis anterior, flexor digitorum longus, extensor hallucis longus, and extensor digitorum longus tendoscopy.
The majority of reviewed studies were Level IV and V, with one Level II study.

Conclusions:

Current literature provides poor evidence (grade Cf) for Achilles, flexor hallucis longus, and peroneal tendoscopy.
Insufficient evidence (grade I) precludes recommendations for or against tendoscopy of several other foot and ankle tendons.
Higher-level evidence studies are necessary to support stronger recommendations for foot and ankle tendoscopy.