Skip to main content
SpringerLink
Log in

The Plantaris Tendon Option for Anatomical Reconstruction

  • Chapter
  • First Online:
Lateral Ankle Instability

  • 905 Accesses

Abstract

Anatomical reconstructions are the preferred option when ligament remnants are absent or of low quality. In these cases, the plantaris tendon is a viable option for lateral ligament reconstruction.

The plantaris tendon can be found, proximally, between the gastrocnemius and soleus muscles, running in a distal and medial direction, before lying parallel to the Achilles tendon. It is reported to be absent in up to 19.2% of the population. Biomechanical studies support the assumption that the plantaris tendon has enough tensile strength for anatomical reconstruction of the lateral ankle ligaments.

Surgeons should be aware of possible involvement of the plantaris tendon in patients with previous Achilles tendinopathy. Magnetic resonance imaging, or ultrasound, can be used to assess location and status of the plantaris tendon preoperatively. Proximal and distal approaches for harvesting the tendon are here presented. Harvesting can also be performed with arthroscopic assistance.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 179.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. van Sterkenburg MN, Kerkhoffs GMMJ, Kleipool RP, Niek van Dijk C. The plantaris tendon and a potential role in mid-portion Achilles tendinopathy: an observational anatomical study. J Anat. 2011;218:336–41. https://doi.org/10.1111/j.1469-7580.2011.01335.x.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Jackson JB, Philippi MT, Kolz CW, Suter T, Henninger HB. Characterization of Plantaris tendon constructs for ankle ligament reconstruction. Foot Ankle Int. 2014;35:922–8. https://doi.org/10.1177/1071100714539663.

    Article  PubMed  Google Scholar 

  3. Waldrop NE III, Wijdicks CA, Jansson KS, LaPrade RF, Clanton TO. Anatomic suture anchor versus the Brostrom technique for anterior talofibular ligament repair: a biomechanical comparison. Am J Sports Med. 2012;40:2590–6. https://doi.org/10.1177/0363546512458420.

    Article  PubMed  Google Scholar 

  4. Attarian DE, McCrackin HJ, DeVito DP, McElhaney JH, Garrett WE. Biomechanical characteristics of human ankle ligaments. Foot Ankle. 1985;6:54–8. https://doi.org/10.1177/107110078500600202.

    Article  CAS  PubMed  Google Scholar 

  5. Spang C, Alfredson H, Docking SI, Masci L, Andersson G. The plantaris tendon: a narrative review focusing on anatomical features and clinical importance. Bone Joint J. 2016;98-B:1312–9. https://doi.org/10.1302/0301-620X.98B10.37939.

    Article  CAS  PubMed  Google Scholar 

  6. Pereira H, Vuurberg G, Spennacchio P, Batista J, D’Hooghe P, Hunt K, Van Dijk N. Surgical treatment paradigms of ankle lateral instability, osteochondral defects and impingement. Adv Exp Med Biol. 2018;1059:85–108. https://doi.org/10.1007/978-3-319-76735-2_4.

    Article  CAS  PubMed  Google Scholar 

  7. Vuurberg G, Pereira H, Blankevoort L, van Dijk CN. Anatomic stabilization techniques provide superior results in terms of functional outcome in patients suffering from chronic ankle instability compared to non-anatomic techniques. Knee Surg Sports Traumatol Arthrosc. 2018;26:2183–95. https://doi.org/10.1007/s00167-017-4730-4.

    Article  CAS  PubMed  Google Scholar 

  8. Hua Y, Chen S, Jin Y, Zhang B, Li Y, Li H. Anatomical reconstruction of the lateral ligaments of the ankle with semitendinosus allograft. Int Orthop. 2012;36:2027–31. https://doi.org/10.1007/s00264-012-1577-7.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Pagenstert GI, Valderrabano V, Hintermann B. Lateral ankle ligament reconstruction with free plantaris tendon graft. Tech Foot Ankle Surg. 2005;4:104–12. https://doi.org/10.1097/01.btf.0000152574.09654.80.

    Article  Google Scholar 

  10. Guillo S, Archbold P, Perera A, Bauer T, Sonnery-Cottet B. Arthroscopic anatomic reconstruction of the lateral ligaments of the ankle with gracilis autograft. Arthrosc Tech. 2014;3:e593–8. https://doi.org/10.1016/j.eats.2014.06.018.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Diniz P, Pacheco J, Flora M, Quintero D, Stufkens S, Kerkhoffs G, Batista J, Karlsson J, Pereira H. Clinical applications of allografts in foot and ankle surgery. Knee Surg Sports Traumatol Arthrosc. 2019;27:1847–72. https://doi.org/10.1007/s00167-019-05362-0.

    Article  PubMed  Google Scholar 

  12. Tourné Y, Mabit C. Lateral ligament reconstruction procedures for the ankle. Orthop Traumatol Surg Res. 2017;103:S171–81. https://doi.org/10.1016/j.otsr.2016.06.026.

    Article  PubMed  Google Scholar 

  13. Dekker M, Bender J. Results of surgical treatment of rupture of the Achilles tendon with use of the plantaris tendon. Arch Chir Neerl. 1977;29:39–46.

    CAS  PubMed  Google Scholar 

  14. Lynn TA. Repair of the torn Achilles tendon, using the plantaris tendon as a reinforcing membrane. J Bone Joint Surg Am. 1966;48:268–72.

    Article  CAS  PubMed  Google Scholar 

  15. Hansen BH. Reconstruction of the peroneal retinaculum using the plantaris tendon: a case report. Scand J Med Sci Sports. 1996;6:355–8. https://doi.org/10.1111/j.1600-0838.1996.tb00107.x.

    Article  CAS  PubMed  Google Scholar 

  16. Bertelli JA, Santos MA, Kechele PR, Rost JR, Tacca CP. Flexor tendon grafting using a plantaris tendon with a fragment of attached bone for fixation to the distal phalanx: a preliminary cohort study. J Hand Surg. 2007;32:1543–8. https://doi.org/10.1016/j.jhsa.2007.08.022.

    Article  Google Scholar 

  17. Spina AA. The plantaris muscle: anatomy, injury, imaging, and treatment. J Can Chiropr Assoc. 2007;51:158–65.

    PubMed  PubMed Central  Google Scholar 

  18. van Sterkenburg MN, van Dijk CN. Mid-portion Achilles tendinopathy: why painful? An evidence-based philosophy. Knee Surg Sports Traumatol Arthrosc. 2011;19:1367–75. https://doi.org/10.1007/s00167-011-1535-8.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Nayak SR, Krishnamurthy A, Prabhu LV, Madhyastha S. Additional tendinous origin and entrapment of the plantaris muscle. Clinics (Sao Paulo, Brazil). 2009;64:67–8. https://doi.org/10.1590/s1807-59322009000100012.

    Article  Google Scholar 

  20. Wehbé MA. Tendon graft donor sites. J Hand Surg. 1992;17:1130–2. https://doi.org/10.1016/s0363-5023(09)91079-6.

    Article  Google Scholar 

  21. Daseler E, Anson B. The plantaris muscle an anatomical study of 750 specimens. J Bone Joint Surg. 1943;25:822.

    Google Scholar 

  22. Attarian DE, McCrackin HJ, Devito DP, McElhaney JH, Garrett WE. A biomechanical study of human lateral ankle ligaments and autogenous reconstructive grafts. Am J Sports Med. 1985;13:377–81. https://doi.org/10.1177/036354658501300602.

    Article  CAS  PubMed  Google Scholar 

  23. Hintermann B, Renggli P. [Anatomic reconstruction of the lateral ligaments of the ankle using a plantaris tendon graft in the treatment of chronic ankle joint instability]. Orthopade. 1999;28:778–84.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Hospital de Sant’Ana, Parede, Portugal

    Pedro Diniz

  2. Institute for Bioengineering and Biosciences, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal

    Pedro Diniz

  3. Fisiogaspar, Lisbon, Portugal

    Pedro Diniz

  4. Department of Applied Anatomy in Orthopedic Physiatry and Traumatology of the Museum of Morphological Sciences of the Chair of Normal Anatomy of the Faculty of Medical Sciences, Rosario University, Rosário, Argentina

    Diego Quintero & Lautaro Ezpeleta

  5. Orthopedic Reconstructive Foot & Ankle Surgery Unit, Cairo, Egypt

    Nasef Abdelatif

  6. Clinical Department Club Atletico Boca Juniores, CAJB – Centro Artroscopico, Buenos Aires, Argentina

    Jorge Batista

  7. Knee and Ankle Orthopaedic Department, Centro Hospitalar Póvoa de Varzim, Vila do Conde, Portugal

    Hélder Pereira

  8. Ripoll y De Prado Sports Clinic: FIFA Medical Centre of Excellence, Murcia-Madrid, Spain

    Hélder Pereira

  9. ICVS/3B’s – PT Government Associate Laboratory, University of Minho, Braga/Guimarães, Portugal

    Hélder Pereira

Authors
  1. Pedro Diniz
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Diego Quintero
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lautaro Ezpeleta
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Nasef Abdelatif
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jorge Batista
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hélder Pereira
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Póvoa de Varzim-Vila do Conde Hospital Centre, Minho university, Braga-Guimarães, Portugal

    Hélder Pereira

  2. SOS Pied Cheville Bordeaux, Bordeaux-Mérignac, France

    Stéphane Guillo

  3. Queen Elizabeth II Health Sciences Center & Dalhousie University, Halifax, NS, Canada

    Mark Glazebrook

  4. Clinical and Research Institute for Foot and Ankle Surgery, Jujo Hospital, Kisarazu, Chiba, Japan

    Masato Takao

  5. Imperial College London and Fortius Clinic London, London, UK

    James Calder

  6. FIFA Medical centre of excellence Madrid and Porto, Department of Orthopaedic Surgery, University of Amsterdam, Academic Medical Centre, Amsterdam, The Netherlands

    Niek Van Dijk

  7. Department of Orthopaedics, Sahlgrenska University Hospital, Mölndal, Sweden

    Jón Karlsson

Rights and permissions

Reprints and permissions

Copyright information

© 2021 ESSKA

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Diniz, P., Quintero, D., Ezpeleta, L., Abdelatif, N., Batista, J., Pereira, H. (2021). The Plantaris Tendon Option for Anatomical Reconstruction. In: Pereira, H., et al. Lateral Ankle Instability. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-62763-1_32

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-62763-1_32

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-62762-4

  • Online ISBN: 978-3-662-62763-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation