Peroneus Longus to Peroneus Brevis Tenodesis Does Not Improve Ankle Functional Outcomes: A Prospective Cohort Study

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomechanical Research

Background:

• Peroneus longus (PL) graft harvest is increasingly used in ligament reconstruction.
• Standard PL harvest technique includes tenodesis of the PL stump to the peroneus brevis (PB).
• Limited evidence exists comparing functional outcomes of tenodesis versus no tenodesis.

Purpose of the Study:

• To evaluate the impact of tenodesis on post-operative ankle functional outcome scores after PL graft harvest.
• To compare functional outcomes between patients who underwent tenodesis and those who did not.

Main Methods:

• Prospective cohort study of 200 patients undergoing PL graft harvest.
• Patients were divided into tenodesis (n=128) and no tenodesis (n=72) groups.
• Pre-operative and post-operative (6 weeks, 3 months, 6 months, 1 year) American Orthopaedic Foot and Ankle Society (AOFAS) and Functional Ankle Disability Index (FADI) scores were assessed.

Main Results:

• No significant difference in AOFAS and FADI scores between groups at any follow-up interval, except for slightly better scores in the no tenodesis group at 6 weeks (p<0.05), which were not clinically significant.
• The magnitude of difference in scores at 6 weeks was minimal.
• Age, gender, and level of play did not influence ankle functional outcomes.

Conclusions:

• Tenodesis of the PL to the PB does not enhance post-operative ankle functional outcome scores compared to no tenodesis.
• Further research is warranted to investigate the biomechanical effects (eversion, plantarflexion, gait) of tenodesis versus no tenodesis.