Tendinopath of the anterior compartment of the ankle

Abstract

Objective: To carry out a retrospective analysis on the etiopathogenesis, diagnosis and therapeutic options in cases of tendinopathy of the anterior compartment of the ankle. Method: 13 patients underwent surgery between September 1998 and February 2009; ten men and three women. The right side was involved in twelve patients and the left in one. The mean age was 35 years (range 15-67). The etiology was traumatic in eight patients and degenerative (non-traumatic) in five. The mean time elapsed between diagnosis and treatment was 19 months (range 1 - 60) and the mean length of follow-up was 34 months (range 4 - 127). The diagnosis was made through anamnesis and clinical examination. Magnetic resonance imaging was performed on nine patients, for staging and planning. The surgical treatment was personalized in each case (synovectomy, resection of the muscle belly, consolidation with the adjacent tendon, and free grafting of the semitendinosus tendon). The following scales were used to evaluate the results: 1) subjective satisfaction scale, 2) AOFAS and 3) Maryland. Results: In relation to the subjective satisfaction scale, 12 patients were satisfied and one was dissatisfied. The mean AOFAS score was 80 points, and the mean Maryland scale was 86 points. Conclusion: Surgical treatment is effective for restoring function. The surgical techniques need to be personalized. The option of free grafting of the semitendinosus tendon is effective for gaps larger than five centimeters.