Association of Tibialis Posterior Tendon Pathology with Other Radiographic Findings in the Foot: A Case-Control Study

Shibuya, Naohiro; Ramanujam, Crystal L.; Garcia, Glenn M.

doi:10.1053/j.jfas.2008.08.010

Cited by 38 publications

(25 citation statements)

References 24 publications

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“…In line with classification systems [1, 7, 8, 38] and consistent with other studies [39], this suggests that changes in foot posture may not be a key feature of stage I PTTD. Differences between stage I and II PTTD also appear to relate to muscle function.…”

Section: Discussionsupporting

confidence: 91%

Self‐reported social and activity restrictions accompany local impairments in posterior tibial tendon dysfunction: a systematic review

Ross

Smith

Plinsinga

et al. 2018

Journal of Foot and Ankle Research

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BackgroundPosterior tibial tendon dysfunction (PTTD) is a painful, progressive tendinopathy that reportedly predominates in middle-age, overweight women. There is no evidence based guidelines that clinicians can use to guide treatment planning, which leaves clinicians to make decisions on the basis of presenting clinical impairments and self-reported pain and disability. The purpose of this systematic review was to quantify clinical impairments, pain and disability in individuals with PTTD compared with controls.MethodsFive databases were searched for terms referring to the posterior tibial tendon and flatfoot up to and including 11 March 2018. The systematic review was registered with PROSPERO (CRD: 42016046951). Studies were eligible if they were published in the English language and contained data on clinical impairments, pain or disability compared between participants diagnosed with PTTD and pain-free individuals. Standardised mean differences (SMDs) were calculated where possible and meta-analysis was performed when homogeneity of outcomes allowed.ResultsTen eligible studies were identified and pooled in the meta-analyses. Strong effects were revealed for poor heel rise endurance (SMD -1.52, 95% CI -2.05 to − 0.99), less forefoot adduction-inversion strength (SMD -1.19, 95% CI -1.68 to − 0.71) and lower arch height (SMD -1.76, 95% CI -2.29 to − 1.23). Compared to controls, individuals with PTTD also had more self-reported stiffness (SMD 1.45, 95% CI 0.91 to 1.99), difficulties caused by foot problems (SMD 1.42, 95% CI 0.52 to 2.33) and social restrictions (SMD1.26, 95% CI 0.25 to 2.27).ConclusionThere is evidence of impaired tibialis posterior capacity and lowered arch height in individuals with PTTD compared to controls. Further to addressing the expected impairments in local tendon function and foot posture, pain, stiffness, functional limitations and social participation restrictions should be considered when managing PTTD.Electronic supplementary materialThe online version of this article (10.1186/s13047-018-0292-z) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 91%

Self‐reported social and activity restrictions accompany local impairments in posterior tibial tendon dysfunction: a systematic review

Ross

Smith

Plinsinga

et al. 2018

Journal of Foot and Ankle Research

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“…Shibuya et al 30 also reported no differences in talar declination angle, or Meary's angle, between individuals with stage I PTTD and healthy controls, as measured using radiographs. However, these authors did not measure AHI, so comparisons are difficult.…”

Section: Discussionmentioning

confidence: 95%

“…Dyal et al 4 also reported that a lower arch height was associated with the symptomatic PTTD foot compared to the uninvolved foot. In contrast, Shibuya et al 30 reported that radiographic and MRI scans of patients with PTTD at various stages showed damage to the spring ligament, with a lower arch height only present in patients with stages III and IV PTTD. Thus reduced arch height may be a predisposing factor related to stages III and IV PTTD, while a more typical arch height would be expected in stage I PTTD.…”

Section: Biomechanical and Clinical Factors Related To Stage I Posteriormentioning

confidence: 91%

Biomechanical and Clinical Factors Related to Stage I Posterior Tibial Tendon Dysfunction

Rabbito

Pohl²,

Humble³

et al. 2011

J Orthop Sports Phys Ther

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Posterior tibial tendon dysfunction (PTTD) is a progressive and debilitating condition that is estimated to affect nearly 5 million people in the United States. 7 In the early stages (stage I) of the condition, PTTD is a common running-related injury. 31While the aetiology of PTTD has not been established, it is considered multifactorial in nature and has generally been related to progressive alterations in arch structure, muscular strength, and gait biomechanics. T T BACKGROUND:PTTD is a progressive condition, so early recognition and treatment are essential to help delay or reverse the progression. However, no previous studies have investigated stage I PTTD, and no single study has measured static anatomical structure, muscle strength, and gait mechanics in this population. T T METHODS: Twelve individuals with stage I PTTDand 12 healthy, age-and gender-matched control subjects, who were engaged in running-related activities, participated in this study. Measurements of arch height index, maximum voluntary ankle invertor muscle strength, and 3-dimensional rearfoot and medial longitudinal arch kinematics during walking were obtained. T T RESULTS:The runners with PTTD demonstrated significantly lower seated arch height index (P = .02) and greater (P = .03) and prolonged (P = .05) peak rearfoot eversion angle during gait, compared to the healthy runners. No differences were found in standing arch height index values (P = .28), arch rigidity index (P = .06), ankle invertor strength (P = .49), or peak medial longitudinal arch values (P = .49) between groups. T T CONCLUSION:The increased foot pronation is hypothesized to place greater strain on the posterior tibialis muscle, which may partially explain the progressive nature of this condition.

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“…In the sagittal plane, the talar angle [11], talocalcaneal inclination angle [12], tarsal index [12], and the talar declination angle [13] (by using the talar axis as described by Ellis et al [5]) were determined. The tarsal index as described by Benink [12] was calculated with the following formula: in which TI is the tarsal index, TCO the talocalcaneal overlap, TL the talar length, and TCI the talocalcaneal inclination angle.…”

Section: Methodsmentioning

confidence: 99%

The reliability and validity of radiographic measurements for determining the three-dimensional position of the talus in varus and valgus osteoarthritic ankles

et al. 2012

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ObjectiveTo assess the most accurate radiographic method to determine talar three-dimensional position in varus and valgus osteoarthritic ankles, we evaluated the reliability and validity of different radiographic measurements.Materials and methodsNine radiographic measurements were performed blindly on weight-bearing mortise, sagittal, and horizontal radiographs of 33 varus and 33 valgus feet (63 patients). Intra- and interobserver reliability was determined with the intraclass coefficient (ICC). Discriminant validity of measurements between varus and valgus feet was assessed with effect size (ES). Convergent validity (Pearson’s r) was evaluated by correlating measurements to the dichotomized varus and valgus groups. Obtained measurements in both groups were finally compared with each other and with 30 control feet.ResultsReliability was excellent (ICC > 0.80) in all but two measurements. Whereas frontal plane validity was excellent (ES and r > 0.80), horizontal and sagittal measurements showed poor to moderate validity (ES and r between 0.00 and 0.60). Four measurements were significantly different among all groups (p < 0.05). Talar positional tendency was found towards dorsiflexion or endorotation in the varus group and towards plantarflexion or exorotation in the valgus group. The frontal tibiotalar surface angle, sagittal talocalcaneal inclination angle, and horizontal talometatarsal I angle showed the best reliability, validity, and difference among the groups.ConclusionThe frontal tibiotalar surface angle, sagittal talocalcaneal inclination angle, and horizontal talometatarsal I angle accurately determine talar three-dimensional radiographic position in weight-bearing varus and valgus osteoarthritic ankles. Careful radiographic evaluation is important, as these deformities affect talar position in all three planes.

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Association of Tibialis Posterior Tendon Pathology with Other Radiographic Findings in the Foot: A Case-Control Study

Cited by 38 publications

References 24 publications

Self‐reported social and activity restrictions accompany local impairments in posterior tibial tendon dysfunction: a systematic review

Self‐reported social and activity restrictions accompany local impairments in posterior tibial tendon dysfunction: a systematic review

Biomechanical and Clinical Factors Related to Stage I Posterior Tibial Tendon Dysfunction

The reliability and validity of radiographic measurements for determining the three-dimensional position of the talus in varus and valgus osteoarthritic ankles

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