Background: Clinical data are limited for allograft reconstruction of peroneus brevis tears, and its complication profile remains poorly defined. Methods: Retrospective chart review was conducted for patients with peroneus brevis tears who underwent tendon reconstruction with semitendinosus allograft at a single tertiary center between March 2010 and July 2019. A total of 68 patients (69 feet), 24 men and 44 women, were identified with mean age at surgery 51.8 (range, 23-74) years and mean follow-up 20.2 (range, 3.4-71.4) months. At the time of chart review, patients were contacted by phone to assess satisfaction, brace use, and work status. Results: Visual analog scale (VAS) pain score was significantly lower postoperatively (4.0 ± 2.7 vs 2.4 ± 2.8, P = .0018) in the 54 patients with VAS pain data. A total of 40 (58%) feet had at least 1 complication. The most common complications were sural neuralgia in 18 (26%) feet and allograft failure in 7 (10%) feet. Fifteen feet (21%) required reoperation, including 7 for graft failure. In the 30 feet with prior peroneal tendon surgery, there was no association between prior surgery and complications ( P = .21). Of the 24 (35%) patients available for phone survey, 20 (83%) were employed prior to surgery and 18 (90%) of these employed patients returned to work and 14 (58%) did not use an assistive device at final follow-up. Sixteen (67%) of the 24 patients contacted reported being very satisfied or satisfied with the procedure. Conclusion: This is the largest case series to date, demonstrating significant pain improvement and high return-to-work rates in complex cases, but also a 58% overall complication rate and 10% graft failure. Allograft reconstruction may be effective when few options exist, yet careful patient selection and awareness of technical challenges are essential. Level of Evidence: Level IV, case series.
Hembree et al. (Thu,) studied this question.