Tendoscopy: A novel way to look at an Enigma; Indications,Technique & Results of managing tendon pathologies in foot and ankle

Abhishek Kini, Amit Munde

Volume 3 | Issue 2 | May – Aug 2018 | Page 24-29

Author: Abhishek Kini [1], Amit Munde [1].

[1] Department of Orthopaedics, P.D.Hinduja Hospital& Medical Research Centre, Mumbai, India.

Address of Correspondence
Dr. Abhishek Kini,
Dept. of Orthopaedics, PD Hinduja hospital & Medical research centre, Mahim, Mumbai, India.
Email: kiniabhishek@gmail.com

Abstract

Background: Lack of consensus remains regarding management of the myriad of etiologies that affect the tendons traversing the hindfoot. Commonly affected tendons include the peroneals, flexor hallucis longus (FHL), tibialis posterior and the Achilles tendons. Tendoscopy is a largely unexplored approach in treatment of these varied causes. There is not enough international literature available on the utility of this novel technique. With this paper we aim to study the indications for tendoscopy, describe its technique and present its results.
Methods: Sixteen patients with failed conservative care for the above mentioned tendon related complaints were treated tendoscopically from June 2013 to December 2015. We detail the surgical steps to perform tendoscopy. Age, gender, timing of surgery, work & activity demands, preop & 6 months postop AOFAS hindfoot score were noted. At final followup patients were asked to rate their overall result as excellent, good, fair or poor & whether they were satisfied.
Results: Five patients had peroneal tendon, six patients had FHL, two tibialis posterior tendon and 3 Achilles tendon pathologies. 11 active high demand individuals were part of this group and all of these could resume their high demand activity by 6 to 12 weeks. AOFAS hindfoot score improved from 58.6 +/-8.9 to 81.3 +/-7.1 (p>0.05). All patients were satisfied with their surgical outcome.
Conclusion: Tendoscopy is a safe technique to treat the tendons traversing the hindfoot. Advantage being ability to examine longer length of tendon in a minimally invasive manner leading to low morbidity, early recovery to activities.

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