Department of Orthopaedic Surgery, NYU Langone Health, New York, NY.
Department of Orthopedic Surgery, Robert Wood Johnson Barnabas Health, Jersey City Medical Center, Jersey City, NJ.
J Foot Ankle Surg. 2021 Sep-Oct;60(5):1008-1013. doi: 10.1053/j.jfas.2021.03.003. Epub 2021 Mar 10.
The purpose of this study was to provide an overview of the available evidence on peroneal tendon tears and the outcomes after surgical intervention. A systematic review of the literature was performed using MEDLINE, Embase, and Cochrane. Criteria for inclusion were clinical studies reporting outcomes after treatment for peroneal tendon tear within the last 10 years. Nine studies evaluating 336 patients (146 males/190 females) and 336 ankles were included in this review. The mean age of included patients was 46.3 years (range, 46-56.9 years). The weighted mean follow-up was 23.82 months (range 9.2-78 months. Five surgical interventions were reported: primary repair with tenodesis, primary repair without tenodesis, FDL tendon transfer, FHL tendon transfer, and allograft reconstruction. Four studies recorded the AOFAS score, with a weighted mean preoperative score of 69.58 and a weighted mean postoperative score of 88.82. Six studies measured the VAS score showing an improvement from a mean weighted preoperative score of 4.68 to a mean weighted postoperative score of 1.2. FAAM score was measured in 3 studies, which showed an improvement from 41.1 preoperatively to 84.4 postoperatively. The average overall complication rate was 38.7% (130/336) with the most commonly reported minor complication being ankle pain, which made up 46.2% of all minor complications (56/121). Primary repair without tenodesis was associated with a higher complication rate compared to any other surgical intervention (p=.001176). The current systematic review showed that overall clinical outcomes were positive in lieu of the different modalities of surgical intervention for peroneal tendon tears.
本研究旨在提供对腓骨肌腱撕裂和手术干预后结果的现有证据的概述。使用 MEDLINE、Embase 和 Cochrane 进行了文献系统回顾。纳入标准为在过去 10 年内报告腓骨肌腱撕裂治疗后结局的临床研究。本综述纳入了 9 项研究，共评估了 336 例患者（146 名男性/190 名女性）和 336 例踝关节。纳入患者的平均年龄为 46.3 岁（范围，46-56.9 岁）。加权平均随访时间为 23.82 个月（范围 9.2-78 个月）。报告了 5 种手术干预措施：带肌腱止点的原发性修复、不带肌腱止点的原发性修复、FDL 肌腱转移、FHL 肌腱转移和同种异体重建。4 项研究记录了 AOFAS 评分，加权平均术前评分为 69.58，加权平均术后评分为 88.82。6 项研究测量了 VAS 评分，显示从平均加权术前评分 4.68 改善至平均加权术后评分 1.2。3 项研究测量了 FAAM 评分，显示从术前 41.1 分改善至术后 84.4 分。总体并发症发生率平均为 38.7%（130/336），最常见的报告的轻微并发症是踝关节疼痛，占所有轻微并发症的 46.2%（56/121）。与任何其他手术干预相比，不带肌腱止点的原发性修复的并发症发生率更高（p=.001176）。本系统综述表明，不同的腓骨肌腱撕裂手术干预方式总体上临床结局均为积极的。
