Endoscopic Repair of a Subluxing Peroneal Tendon Complex

Surgical Technique

Foot Ankle Stud. 2017; 1(1): 1004.

Endoscopic Repair of a Subluxing Peroneal Tendon Complex

Nodelman L¹ and Theodoulou MH²*

¹Deapartment of Foot & Ankle, Private Practice, Center for Foot and Ankle Care, USA

²Department of Foot & Ankle, Instructor of Surgery, Harvard Medical School, USA

*Corresponding author: Theodoulou MH, Department of Foot & Ankle, Instructor of Surgery, Harvard Medical School, USA

Received: January 17, 2017; Accepted: February 24, 2017; Published: March 10, 2017


Peroneal tendon subluxation has typically been approached through an extensile technique. Reports of endoscopic technique to facilitate repair of the superior peroneal retinaculum are rare in the literature. In this technique paper we present our endoscopic approach to repair of a subluxing peroneal tendon complex.

Keywords: SPR repair; Peroneal tendon dislocation; Peroneal tendon subluxation; Tendoscopy


Tendoscopy of the peroneal tendon complex has proven to be a useful tool to assist with diagnosis, debridement of synovitic tissue, release of adhesions, removal of distal muscle belly or peroneus quartus, groove deepening, superior peroneal retinaculum repair, debridement of tendon rupture and even tendon repair [1]. It is important to review the mainstay classification schemes because correctly characterizing pathology may assist with pre-operative planning, especially if deciding between an open or endoscopic procedure (Figures 1-4). Eckert and Davis characterized peroneal subluxation into three grades: Grade 1, Superior Peroneal Retinaculum (SPR) is elevated off the fibula; Grade 2, the fibrocartilagenous ridge avulses together with the SPR; Grade 3, avulsion of a small piece of cortical bone [2]. Raikin et al. characterized intra-sheath peroneal subluxation into two subtypes and likely what determines whether one approaches repair through an open technique or endoscopically: Type A, intra-sheath subluxation with an intact peroneus brevis tendon; Type B, intra-sheath subluxation with associated longitudinal tear of the peroneus brevis tendon [3]. Endoscopic repair is attractive for numerous reasons. Open surgical technique are not without morbidity including potential healing issues associated with a larger incision, infection and scar formation. It has been proposed that the mere act of dissection inherent to open surgery results in sectioning of the stabilizing structures that require repair