Comparison of preoperative MRI and intraoperative findings of posterior tibial tendon insufficiency

Abstract

BackgroundThe purpose of this study was to investigate the radiological and surgical correlation between preoperative magnetic resonance images (MRI) and the intraoperative findings in patients with acquired adult flatfoot.ResultsThe overall radiological–surgical correlation between preoperative MRI and the intraoperative findings for posterior tibial tendon insufficiency was only slight to fair in our patient’s series. Comparing the most commonly used posterior tibial tendon classification systems, the classification of Rosenberg et al. and Kong et al. showed higher interobserver agreement than our modified classification system and the classification system of Conti et al.ConclusionFurther prospective studies are needed to evaluate the importance of preoperative MRI before surgical repair of posterior tibial tendon dysfunction.

Role of Tendoscopy in Treating Stage II Posterior Tibial Tendon Dysfunction

“…When looking at spring ligament assessment, according to some authors, MRI abnormalities (mostly on the superiormedial bundle) seem to correlate well with operative findings 44,64,65 ; however, recent literature suggests that the concordance may not always be clinically relevant. 7 In our series, MRI accuracy in detecting spring ligament lesions was almost twice that of US (78% vs 42%). This result (as well as for tendon lesions) is probably based on operator dependence in US scanning.…”

Imaging of the Tibionavicular Ligament, and Its Potential Role in Adult Acquired Flatfoot Deformity

“…10 The SLC (superomedial and inferomedial calcaneonavicular ligament), interosseous ligament, plantar metatarsal ligaments, and the plantar naviculocuneiform ligament are all involved. 4 The authors also identified that the deltoid complex was commonly involved, in particular the anterior superficial structures of the complex, which showed a strong statistically significant difference in involvement when compared to a control.…”

“…Consideration and scrutiny of these structures is now generating significant interest. 1,4,6,14,18,22 The PT is a dynamic secondary stabilizer of the medial column. It strengthens the actions of the medial ligamentous structures.…”