Effects of Peroneal Tendon Pathologies in 311 Patients Who Underwent Arthroscopic Repair for Lateral Instability of the Ankle

Abstract

Introduction: Few reports described the effects and clinical outcomes of peroneal tendon pathologies in patients undergoing arthroscopic repair for lateral ankle instability.

Methods: Patients were stratified into those who underwent arthroscopic ankle lateral ligament repair alone (Group N) and those who underwent arthroscopic ankle lateral ligament repair in combination with surgery for peroneal tendon pathologies (Group P). Group P was further divided into patients without peroneal tendon dislocation (Group PT) and those with peroneal tendon dislocation (Group PD). Arthroscopic ankle lateral ligament repair was performed first, followed by additional surgery for peroneal tendon pathology in Group P. Subjective clinical outcome scores were assessed preoperatively and at 2 years postoperatively using the Self-Administered Foot Evaluation Questionnaire (SAFE-Q).

Results: A total of 311 patients who met the inclusion and exclusion criteria were included in this study. There were 248 patients in Group N and 63 patients in Group P. Of the 63 patients in Group P, 46 were classified into Group PT and 17 into Group PD. In all groups, SAFE-Q scores significantly improved in all categories 2 years after surgery compared with preoperatively. At 2 years postoperatively, SAFE-Q scores showed statistically significant differences in all categories between Group P and Group N, Group PT and Group N, and Group PD and Group N (p < 0.0001), with Group N having higher scores.

Conclusions: Although surgical treatment for lateral ankle instability associated with peroneal tendon pathologies was effective, the presence of peroneal tendon pathologies had a negative effect on the postoperative clinical outcomes of arthroscopic repair for lateral ankle instability.

Figure 5Peroneal brevis tendon tear (left) and after debridement (right).The peroneal brevis tendon tears (*) and/or degenerated tendon were treated with debridement and tubularization while preserving the reasonable native tendon (†).*: Dislocated peroneal brevis tendon passing over the posterior edge of the LM.LM: lateral malleolus.