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Effectiveness of Allograft Reconstruction vs Tenodesis for Irreparable Peroneus Brevis Tears: A Cadaveric Model.

Publication ,  Journal Article
Pellegrini, MJ; Glisson, RR; Matsumoto, T; Schiff, A; Laver, L; Easley, ME; Nunley, JA
Published in: Foot Ankle Int
August 2016

BACKGROUND: Irreparable peroneus brevis tendon tears are uncommon, and there is scant evidence on which to base operative treatment. Options include tendon transfer, segmental resection with tenodesis to the peroneus longus tendon, and allograft reconstruction. However, the relative effectiveness of the latter 2 procedures in restoring peroneus brevis function has not been established. METHODS: Custom-made strain gage-based tension transducers were implanted into the peroneus longus and brevis tendons near their distal insertions in 10 fresh-frozen cadaver feet. Axial load was applied to the foot, and the peroneal tendons and antagonistic tibialis anterior and posterior tendons were tensioned to 50% and 100% of physiologic load. Distal tendon tension was recorded in this normal condition and after sequential peroneus brevis-to-longus tenodesis and peroneus brevis allograft reconstruction. Measurements were made in 5 foot inversion/eversion and plantarflexion/dorsiflexion positions. RESULTS: Distal peroneus brevis tendon tension after allograft reconstruction significantly exceeded that measured after tenodesis in all tested loading conditions (P ≤ 0.022). With 50% of physiologic load applied, peroneus brevis tension was 1% to 28% of normal (depending on foot position) after tenodesis and 73% to 101% of normal after allograft reconstruction. Under the 100% loading condition, peroneus brevis tension was 6% to 43% of normal after tenodesis and 88% to 99% of normal after reconstruction with allograft. Distal peroneus longus tension remained within 20% of normal under all operative and loading conditions. CONCLUSION: Allograft reconstruction of a peroneus brevis tendon tear in this model substantially restored distal tension when the peroneal tendons and their antagonists were loaded to 50% and 100% of physiologic load. Tenodesis to the peroneus longus tendon did not effectively restore peroneus brevis tension under the tested conditions. CLINICAL RELEVANCE: Because tenodesis was demonstrated to be ineffective for restoration of peroneus brevis function, this procedure may result in an imbalanced foot clinically.

Duke Scholars

Published In

Foot Ankle Int

DOI

EISSN

1944-7876

Publication Date

August 2016

Volume

37

Issue

8

Start / End Page

803 / 808

Location

United States

Related Subject Headings

  • Tenodesis
  • Tendons
  • Tendon Injuries
  • Rupture
  • Orthopedics
  • Middle Aged
  • Male
  • Humans
  • Female
  • Cadaver
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Pellegrini, M. J., Glisson, R. R., Matsumoto, T., Schiff, A., Laver, L., Easley, M. E., & Nunley, J. A. (2016). Effectiveness of Allograft Reconstruction vs Tenodesis for Irreparable Peroneus Brevis Tears: A Cadaveric Model. Foot Ankle Int, 37(8), 803–808. https://doi.org/10.1177/1071100716658469
Pellegrini, Manuel J., Richard R. Glisson, Takumi Matsumoto, Adam Schiff, Lior Laver, Mark E. Easley, and James A. Nunley. “Effectiveness of Allograft Reconstruction vs Tenodesis for Irreparable Peroneus Brevis Tears: A Cadaveric Model.Foot Ankle Int 37, no. 8 (August 2016): 803–8. https://doi.org/10.1177/1071100716658469.
Pellegrini MJ, Glisson RR, Matsumoto T, Schiff A, Laver L, Easley ME, et al. Effectiveness of Allograft Reconstruction vs Tenodesis for Irreparable Peroneus Brevis Tears: A Cadaveric Model. Foot Ankle Int. 2016 Aug;37(8):803–8.
Pellegrini, Manuel J., et al. “Effectiveness of Allograft Reconstruction vs Tenodesis for Irreparable Peroneus Brevis Tears: A Cadaveric Model.Foot Ankle Int, vol. 37, no. 8, Aug. 2016, pp. 803–08. Pubmed, doi:10.1177/1071100716658469.
Pellegrini MJ, Glisson RR, Matsumoto T, Schiff A, Laver L, Easley ME, Nunley JA. Effectiveness of Allograft Reconstruction vs Tenodesis for Irreparable Peroneus Brevis Tears: A Cadaveric Model. Foot Ankle Int. 2016 Aug;37(8):803–808.
Journal cover image

Published In

Foot Ankle Int

DOI

EISSN

1944-7876

Publication Date

August 2016

Volume

37

Issue

8

Start / End Page

803 / 808

Location

United States

Related Subject Headings

  • Tenodesis
  • Tendons
  • Tendon Injuries
  • Rupture
  • Orthopedics
  • Middle Aged
  • Male
  • Humans
  • Female
  • Cadaver