Preoperative Gait Analysis of Operatively Characterized Peroneal Tendon Tears
2Foot and Ankle OAD, Baylor University Medical Center, USA
Background:
Little is known regarding the impact of peroneal tendon tears on function. This study quantifies gait changes associated with operatively-confirmed peroneal tendon tears.
Methods:
Sixty-five patients with unilateral peroneal tendon tears were prospectively evaluated using preoperative 3D-multi-segment gait analysis of both limbs. Data were analyzed according to pattern/severity of tears, as confirmed surgically: Peroneus brevis tears, reparable (PBR); peroneus brevis tears, irreparable (PBI); peroneus longus tears, irreparable (PLI); concomitant irreparable tears of both tendons (PBI+PLI). The following parameters were analyzed: ankle sagittal motion, coronal motion, axial rotation, foot progression angle, sagittal power, sagittal moment.
Results:
Twelve patients (18.5%) had the PBR pattern, 37 (56.9%) PBI, 10 (15.4%) PLI, and 6 (9.2%) PBI+PLI. Compared to the contralateral, non-pathologic extremities, limbs with peroneal tears had diminished ankle sagittal motion (mean 23.14 versus 24.30 degrees, p=0.012), ankle/hindfoot axial rotation (6.26 versus 7.23 degrees, p=0.001), sagittal moment (1.16 versus 1.29Nm/kg, p<0.001), and sagittal power (1.24 versus 1.47W/kg, p<0.001). The most severe tear patterns had the greatest derangements in multiple parameters of gait (PBI+PLI > PBI or PLI > PBR). For example, all groups except PBR had loss of ankle sagittal moment and/or power in the affected limb, and the greatest losses in moment and power were in the PBI+PLI group (1.22 versus 0.91Nm/kg, p=0.003 for moment; 0.73 versus 1.31W/kg, p10-degree varus shift in coronal motion on the affected side (p=0.002).
Conclusion:
This is the first study to demonstrate diminished biomechanical function in patients with peroneal tendon tears. In-vivo 3-dimensional gait analysis found significant changes in hindfoot motion, ankle motion, and ankle power. Impairments were related to the pattern and severity of the tears, and demonstrated a[CS1] strong association of peroneal tendon tears with diminished ankle plantarflexion strength.