Tendoscopic Groove Deepening for Subluxation or Stenosis of the Peroneal Tendons

Category: Ankle, Arthroscopy, Sports Introduction/Purpose: Peroneal tendon disorders frequently result in refractory posterolateral ankle and hindfoot pain which disables patients from daily activity and sports. Diagnosis can be challenging in certain cases of peroneal tendon pathology, such as subluxation and stenosis. Additionally, traditional open surgery is associated with complications including surgical scarring and injury to the sural nerve. Therefore peroneal tendoscopy has gained popularity as an effective diagnostic and treatment procedure. Recently tendoscopic groove deepening technique has been reported for the treatment of chronic subluxation or stenosing tenosynovitis of peroneal tendons. In this case series, we present the effectiveness of tendoscopic groove deepening procedure for subluxation or stenosis of the peroneal tendons. Methods: A retrospective cohort study investigating patients treated with tendoscopic groove deepening the fibular groove and concentrated bone marrow (CBMA) injection for the treatment of peroneal subluxation or stenosing peroneal tenosynovitis. Retrospective chart review was performed, and clinical outcomes were evaluated using the Foot and Ankle Outcome Scores (FAOS) and Short-Form 12 (SF-12) preoperatively and at final follow-up. Results: Twenty patients diagnosed with subluxation and/or stenosis were included. The mean age was 35.1±9.2 years and the mean follow-up time was 32.5±12.4 months. Mean symptoms, pain, daily activities, sports activities and quality of life scores in FAOS significantly improved from 56.8, 74.1, 72.3, 36.2 and 22.7 preoperatively to 86.5, 83.2, 92.3, 70.2 and 63.8 postoperatively, respectively at final follow-up (p<0.001). The mean SF-12 significantly improved from 48.7 to 75.8 postoperatively (p<0.001). No superior peroneal retinaculaum repair was perfumed in all subluxation cases. No complications were reported. Conclusion: The current study demonstrates that endoscopic groove deepening of the fibular groove was a reproducible and minimally invasive technique that provided a good clinical outcome for subluxation of the peroneal tendons and stenosing peroneal tenosynovitis.