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The role of the peroneal tendons in passive stabilisation of the ankle joint: an in vitro study

  • Ankle
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Peroneal tendons are known as active stabilizer in acute ankle sprain while an intact ankle mortise and intact lateral ligaments are required for passive stability of the ankle joint. The goal of this study is to determine the peroneal tendons as passive stabilizer in case of lateral ligament instability.

Methods

Twelve (12) human lower leg cadaver specimens underwent a torsion simulation in the testing system, 858 Mini Bionix® (MTS® Systems Corporation, Eden Prairie, MN, USA) and a specially designed mounting platform for the specimens. The preset torsion between tibia and calcaneus was primarily set at 30° of internal rotation during plantar flexion and hindfoot inversion. The resisting torque around mechanical tibial axis was recorded which ensures stability in ankle sprain trauma. The first series of measurements were performed on healthy specimens and the following after transecting structures in following order: ATFL (anterior talofibular ligament) in combination with CFL (calcaneofibular ligament), followed by peroneus longus tendon and finally peroneus brevis tendon.

Results

The combined lateral ATFL and CFL instability shows a decrease of the resisting torque which ensures stability in ankle sprain trauma. Only a transection of PLT with existing lateral dual-ligament instability results in a significant decrease in torque (p < 0.0001).

Conclusion

The PLT has a substantial effect on passive stability at a present lateral ligament lesion in ankle sprain trauma. A deficiency in viscoelastic properties of the peroneus longus tendon must be considered in diagnostic and treatment for ankle instability.

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Acknowledgments

The authors would like to thank Constantin E. Dlaska from the Department of Trauma Surgery, Medical University of Vienna.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria

    Pejman Ziai, Emir Benca, Gobert von Skrbensky & Reinhard Windhager

  2. Institute for Medical Statistics, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria

    Alexandra Graf

  3. Student School of Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria

    Florian Wenzel

  4. Department of Orthopaedics, Medical University of Giessen and Marburg, Klinikstraße 33, 35392, Giessen, Germany

    Erhan Basad

  5. Sporthopaedicum Straubing, Bahnhofsplatz 27, 94315, Straubing, Germany

    Tomas Buchhorn

Authors
  1. Pejman Ziai
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  2. Emir Benca
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  3. Gobert von Skrbensky
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  4. Alexandra Graf
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  5. Florian Wenzel
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  7. Reinhard Windhager
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  8. Tomas Buchhorn
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Correspondence to Pejman Ziai.

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Ziai, P., Benca, E., von Skrbensky, G. et al. The role of the peroneal tendons in passive stabilisation of the ankle joint: an in vitro study. Knee Surg Sports Traumatol Arthrosc 21, 1404–1408 (2013). https://doi.org/10.1007/s00167-012-2273-2

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  • DOI: https://doi.org/10.1007/s00167-012-2273-2

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