Plano Orthopedic Sports Medicine and Spine Center, Plano, TX, USA.
Foot Ankle Int. 2010 Feb;31(2):136-40. doi: 10.3113/FAI.2010.0136.
This study evaluated an acellular dermal matrix allograft augmentation for chronic mid-substance peroneous longus and brevis tendon tears. The hypothesis was that acellular dermal matrix allograft augmentation of chronic longitudinal mid-substance or complete tears of both peroneal tendons provides sufficient initial strength to allow a rapid rehabilitation program.
A consecutive series of mid-substance peroneal tendon tears with tissue loss was prospectively evaluated with demographic data, American Orthopaedic Foot and Ankle Society hindfoot-ankle scores, subjective questionnaires, and functional tests as well as physical examination, pre-operative radiographs, and MRIs. Surgical reconstruction consisted of direct tendon repair, fibular sulcus deepening, and ;;gap jumping'' tubular grafting augmentation using an acellular dermal matrix. A rapid rehabilitation protocol was followed. Eleven cases were included (9 females and 2 males). Average age was 46 (range, 29 to 62) years. Followup was 16.9 (range, 12 to 22) months. Two patients had prior surgery for instability, peroneal tendon debridement, and repair. Four patients had previous tenodesis.
All showed extensive longitudinal tearing or complete peroneal tendon rupture on MRI. The mean postoperative AOFAS hindfoot score was 93.5 (range, 75 to 100). Four patients had 1 cm of calf atrophy. All patients were able to perform single-heel rise, had painless ankle and foot range of motion bilaterally, and eversion/inversion strength was within one half grade of strength of the contralateral side in all patients. No postoperative hindfoot varus was identified.
An acellular dermal matrix graft provided an effective ;;gap jumping'' augmentation for repairs of chronic degenerative peroneal tendon tears.
本研究评估了脱细胞真皮基质同种异体移植物增强治疗慢性中间物质腓骨长肌和短肌肌腱撕裂。假设是，脱细胞真皮基质同种异体移植物增强慢性中间物质或完全撕裂的两个腓肠肌腱提供足够的初始强度，以允许快速康复计划。
前瞻性评估了一系列具有组织损失的中间物质腓肠肌腱撕裂，包括人口统计学数据、美国矫形足踝协会后足-踝关节评分、主观问卷和功能测试以及体格检查、术前 X 线片和 MRI。手术重建包括直接肌腱修复、腓骨沟加深和使用脱细胞真皮基质的“间隙跳跃”管状移植物增强。遵循快速康复方案。纳入 11 例（9 名女性和 2 名男性）。平均年龄为 46 岁（范围 29 至 62 岁）。随访时间为 16.9 个月（范围 12 至 22 个月）。2 例患者因不稳定、腓肠肌腱清创和修复而有既往手术史。4 例患者有先前的肌腱固定术。
所有患者 MRI 均显示广泛的纵向撕裂或完全的腓肠肌腱断裂。术后 AOFAS 后足评分平均为 93.5（范围 75 至 100）。4 例患者有 1 厘米的小腿萎缩。所有患者均能单脚抬起，双侧踝关节和足部活动范围无痛，外翻/内翻力量在所有患者中均为对侧力量的一半。术后未发现后足内翻。
脱细胞真皮基质移植物为慢性退行性腓肠肌腱撕裂的修复提供了有效的“间隙跳跃”增强。
