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Peroneal Tendon Tears

We Should Consider Looking at the Muscle Instead

Res, Lodewijk C. S., BSc; Dixon, Tonya, MD; Lubberts, Bart, MD; Vicentini, Joao R. T., MD; van Dijk, Pim A., MD; Hosseini, Ali, PhD; Guss, Daniel, MD, MBA; DiGiovanni, Christopher W., MD

JAAOS - Journal of the American Academy of Orthopaedic Surgeons: November 15, 2018 - Volume 26 - Issue 22 - p 809–815
doi: 10.5435/JAAOS-D-17-00302
Research Article

Introduction: The purpose of this study was to determine whether tears of the peroneus brevis (PB) tendon correlate with increased fatty infiltration of the PB muscle on MRI compared with musculature without clinical evidence of peroneal pathology.

Methods: Ankle MRI scans of patients with PB tendon tearing (tear group) were compared with those of patients without clinical evidence of peroneal pathology (control group). Two reviewers graded the PB muscle belly according to the Goutallier classification.

Results: Thirty patients were included in each group. The mean Goutallier scores for the tear and control groups were 0.52 (±0.72) and 0.05 (±0.15), respectively (P = 0.0019). The level of interobserver agreement between reviewers was moderate (intraclass correlation coefficient = 0.75; 95% confidence interval, 0.57 to 0.85).

Discussion: Patients with PB tendon tear demonstrate markedly higher grades of fatty degeneration compared with patients without peroneal pathology. The Goutallier classification may become a valuable instrument for assessing the severity of a PB tear.

Level of Evidence: Level III—diagnostic study

From the Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA (Mr. Res, Dr. Dixon, Dr. Lubberts, Dr. Vicentini, Dr. Hosseini, Dr. Guss, and Dr. DiGiovanni), and Orthopedic Research Department, Academisch Medisch Centrum, Universiteit van Amsterdam, Amsterdam, the Netherlands (Dr. van Dijk).

Correspondence to Dr. DiGiovanni cwdigiovanni@partners.org

Dr. Guss or an immediate family member serves as a paid consultant to Extremity Medical; and serves as a board member, owner, officer, or committee member of the American Orthopaedic Foot and Ankle Society. Dr. DiGiovanni or an immediate family member has received royalties from Extremity Medical; is a member of a speakers' bureau or has made paid presentations on behalf of Extremity Medical and Wright Medical Technology; serves as a paid consultant to Cartiva, Extremity Medical, and Wright Medical Technology; has stock or stock options held in CreOsso, Extremity Medical, Paragon 28, and Wright Medical Technology; has received research or institutional support from Wright Medical Technology; and serves as a board member, owner, officer, or committee member of the American Orthopaedic Foot and Ankle Society. None of the following authors or any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Mr. Res, Dr. Dixon, Dr. Lubberts, Dr. Vicentini, Dr. van Dijk, and Dr. Hosseini.

© 2018 by American Academy of Orthopaedic Surgeons
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