Arthroscopy and Tendoscopy in the Treatment of Peroneal Tendon Pathology

Tendoscopies of foot and ankle are relatively safe and effective procedures that can be used as an isolated technique or combined with open procedures. The most commonly performed are for Achilles, flexor hallucis longus, and peroneal tendons. Indications for peroneal tendoscopy include retrofibular pain, tenosynovitis, subluxation or dislocation, intrasheath subluxation, partial tears, impingement of peroneus longus at the peroneal tubercle, postoperative adhesions and scarring, and resection of a peroneus quartus tendon or a bifid peroneus brevis or a low-lying peroneal muscle, superior retinaculum reconstruction, and endoscopic groove deepening. In order to have proper indications and adequate surgical technique, some specific aspects of basic science must be kept in mind. These include anatomy, physiopathology, history and physical examination, and appropriate use of imagenological studies. Peroneal tendoscopy is useful for final diagnosis in order to achieve better incision and timing/planning. Patients also benefit from all the advantages of minimally invasive procedures including less recovery time, earlier sports return, shorter hospital stay, better cosmetics, and finally, higher patient satisfaction.