Patient Outcomes after Peroneal Tendon Surgical Repair: A Retrospective Review

Research Type: Level 3 - Retrospective cohort study, Case-control study, Meta-analysis of Level 3 studies Introduction/Purpose: Peroneal tendon (PT) injuries often require surgical repair when conservative measures fail. Ambiguity regarding PT treatment results in reliance on clinical experience to guide tailored repair. This study investigates patient-reported outcomes of PT repair using sutures, grafts, and bio-inductive implants to provide practical treatment insights. Methods: In this retrospective chart review, 88 patients with partially torn PTs and 17 with fully ruptured PTs from tertiary orthopedic centers were analyzed using Patient-Reported Outcomes Measurement Information Systems (PROMIS) scores preoperatively (pre-op), 1–4 months postoperatively (post-op), and 5–8 months post-op. Comparisons of median PROMIS scores perioperatively via the Wilcoxon Signed-Rank and Bonferroni-adjusted p-value tests provide insights into outcomes of surgical repair techniques based on PT tear severity over time. Results: Partial tears repaired with sutures showed faster recovery and greater pain reduction within 4 months (0.0015) than grafts (0.36). For full ruptures, grafts demonstrated prolonged improvements in physical function at 5–8 months (0.03). Bio-inductive implants enhanced physical function at later stages for partial high-grade tears (0.0015) but required longer recovery periods. Conclusion: Bio-inductive implants are a viable option to enhance functionality at later stages with low reoperation and rejection rates. Treating partial tears with sutures yields faster recovery, while grafts are better suited for full ruptures and cases with restricted tendon vitality. These findings support tailored surgical decision-making based on tear severity and patient characteristics.