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Tendoscopy of the peroneal tendons
1Department of Orthopaedic Surgery, The University of Amsterdam, The Netherlands.
Summary
Tendoscopy effectively diagnoses and treats persistent posterolateral ankle pain by visualizing the peroneal tendons and sheath. This minimally invasive approach, utilizing a two-portal technique, identified novel anatomical structures and successfully managed conditions like adhesions and tendon ruptures.
Area of Science:
- Orthopedics
- Sports Medicine
- Anatomy
Background:
- Persistent posterolateral ankle pain affects patients for over 6 months.
- Symptoms include pain on palpation, positive resistance tests, and swelling.
- Peroneal tendon pathology is a common cause of chronic ankle pain.
Purpose of the Study:
- To evaluate the efficacy of diagnostic and therapeutic tendoscopy for posterolateral ankle pain.
- To investigate the anatomy of the peroneal tendons and tendon sheath.
- To identify new anatomical findings relevant to ankle pain.
Main Methods:
- Anatomic cadaver study followed by a prospective tendoscopy study in nine patients.
- Standard two-portal tendoscopy technique for inspection and surgical intervention.
- Patient follow-up at a mean of 19 months.
Main Results:
- Tendoscopy allowed for well-performed inspection and surgery of peroneal tendons and sheath.
- A previously undescribed structure, the vincula, was consistently found, attaching both tendons.
- Adhesions were resected in four patients, with three becoming symptom-free.
- Successful removal of a prominent peroneal tubercle and suture of a peroneus brevis tendon rupture were achieved.
- No complications were reported.
Conclusions:
- Tendoscopy is a valuable tool for diagnosing and treating posterolateral ankle pain.
- The newly identified vincula may play a role in peroneal tendon mechanics.
- Minimally invasive tendoscopy offers effective management for various peroneal tendon pathologies.