The Role of Cryopreserved Human Amniotic Membrane in the Surgical Repair of Peroneal Tendons: An Infrared Thermography Model (Amniox)

• Change in patient questionnaires describing ankle pain, function & activity limiation [ Time Frame: one year ] [ Designated as safety issue: No ]
• Change in thermal imaging of the patients ankle [ Time Frame: 1 year ] [ Designated as safety issue: No ]
  Take photographic pictures of your ankle with a special thermal imaging camera to measure the amount of inflammation at the surgical site, as well as the opposite ankle for comparison. This camera is non-invasive, non-radiating and painless.

Peroneal tendon tears are a common etiology encountered by foot and ankle surgeons. Like all flexor tendon repairs adhesions are one of the more common challenges after surgery. Peroneal tendon gliding is key to their function as effective plantar flexors and evertors of the hindfoot. Scarring and adhesion correlate directly with the amount of inflammatory reaction at the wound site (Adzick 1994). Our goal is to have a surgical technique that allows for standard suture repair of the tendon yet allows for smooth gliding of the tendon with minimal adhesions. A prospective review on the surgical repair of the peroneal tendons utilizing NEOX™1k (Amniox Medical, Marietta, GA), cryopreserved Human Amniotic Membrane (C-HAM) graft will be performed. The investigators hypothesize that the use of cryopreserved Human Amniotic Membrane in conjunction with a peroneal tendon repair will decrease that amount of inflammation, overall recovery time of surgically repaired peroneal tendon tears, and adhesions.

• Experimental: NEOX™1k tissue
  Group 1 will have standard peroneal repair surgery with the addition of the NEOX™1k tissue.
  Intervention: Biological: NEOX™1k graft
• No Intervention: Control arm without NEOX™1k tissue
  Group 2 will have standard peroneal repair surgery without the use of the NEOX™1k tissue.

Inclusion Criteria:

1. Patients requiring surgical repair of the peroneal tendon
2. Patients who voluntarily consent to research participation
3. Patients over the age of 18

Exclusion Criteria:

1. Patients who display a high surgical risk as determined by the investigative surgeon
2. Previous surgical repair of the peroneal tendon
3. Patients with allergy or history of drug reactions to Ciprofloxacin or Amphotericin B
4. Patients who are pregnant or breast feeding.
5. Patients who have had a clinically diagnosed autoimmune disease
6. Patients who are unwilling to restrict pre and postoperative anti-inflammatories
7. Patients with an active infection
8. Patients who have a medical history that would likely make the patient an unreliable research participant