Surgical Information

Peroneal Tendon Repair

What is peroneal tendon repair?

Peroneal tendon repair is surgery to treat painful tears or recurrent subluxation (dislocation) of the peroneal tendons, which attach the muscles on the outside of your calf to your foot bone. Peroneal tendon injuries may occur suddenly or develop over a period of time. Athletes in sports that involve repetitive ankle motion are at risk. So are people with high arches. A strong force or chronic irritation can tear your peroneal tendons. In addition, the tendons can pop out of the supporting ligaments that hold them in place.

Surgical options include:

  • Tendon debridement. In this procedure, the surgeon divides the sheath around the tendon and clears away degenerated and irritated tissue. The sheath is not stitched back together and eventually fills with scar tissue.
  • Tendon repair. The surgeon divides the sheath around the tendons and, depending on the length of the tear, either removes the torn portion of the tendon or sutures the tear along the length of the tendon. The tendon sheath is repaired.
  • Tendon reconstruction. The diseased portion of the tendon is found to be damaged beyond surgical repair. The diseased portion is removed and replaced with cadaveric (allograft) tendon. For more information regarding tendon reconstruction, please see the following articles:
    Allograft Reconstruction of Peroneal Tendons : Operative Technique and Clinical Outcomes
    Allograft Reconstruction of Irreparable Peroneal Tendon Tears: A Preliminary Report

Anatomy

The two peroneal tendons run side-by-side behind the outer ankle bone. One peroneal tendon attaches to the outer part of the midfoot, while the other attaches near the inside of the arch. The main function of the peroneal tendons is to stabilize the foot and ankle and protect them from sprains. The peroneals are prone to injury as the ankle turns or rolls.

When is surgery recommended?

Peroneal tendon tears or recurrent dislocation are challenging to manage without surgical intervention. Immobilization, braces, physical therapy and anti-inflammatory medications may temporarily relieve symptoms, but they routinely recur when the patient returns to pre-injury activity levels. In these cases, surgery is almost always necessary.

What is the recovery time?

Recovery after surgery usually involves several weeks of restricted weight-bearing and immobilization, depending on the type of surgery performed. Following immobilization, therapy begins to restore strength and range of motion. Total recovery time is typically six to 12 weeks, depending on the extent of surgery. As with all surgical procedures, recovery varies by patient and demand.