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Preoperative Assessment of the Peroneal Tendons in Lateral Ankle Instability: Examining Clinical Factors,Magnetic Resonance Imaging Sensitivity,and Their Relationship
Authors:Parke W Hudson  Cesar de Cesar Netto  Ibukunoluwa B Araoye  Caleb W Jones  Shelby L Bergstresser  Ashish Shah
Institution:1. Research Fellow, Foot and Ankle Surgery, Department of Surgery, Division of Orthopaedics, University of Alabama at Birmingham, Birmingham, AL;2. Clinical Fellow, Foot and Ankle Surgery, Department of Surgery, Division of Orthopaedics, University of Alabama at Birmingham, Birmingham, AL;3. Medical Student, Department of Surgery, Division of Orthopaedics, University of Alabama at Birmingham, Birmingham, AL;4. Assistant Professor, Department of Surgery, Division of Orthopaedics, University of Alabama at Birmingham, Birmingham, AL
Abstract:The purpose of our study was to examine the preoperative clinical factors and magnetic resonance imaging (MRI) findings associated with peroneal pathology in chronic lateral ankle instability patients, as well as the clinical factors associated with peroneal lesions being detected on MRI. Peroneal pathology was determined from intraoperative findings. Patients with/without peroneal pathology were compared regarding their preoperative clinical findings. MRI reports were examined to determine the sensitivity of detecting peroneal pathologies. Clinical factors were compared between patients (N = 238) with undetected and detected peroneal lesions on MRI. Conservative treatment, preoperative physical therapy, and lack of a traumatic inciting event were associated with peroneal pathology. MRI had a sensitivity of 61.11% for detecting peroneal pathology. No clinical factors were significantly different between “detected” and “undetected” cases. Certain historical factors were associated with peroneal pathology in patients with chronic lateral ankle instability, and MRI had a high false-negative rate. Surgeons should exercise caution when ruling out peroneal pathology based on preoperative physical examination or MRI.
Keywords:3  lateral ankle instability  MRI  peroneal pathology  physical therapy  reconstruction  sports
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