Functional Outcomes of Tibialis Posterior Tendoscopy With Comparison to Magnetic Resonance Imaging

Adult-acquired flatfoot deformity (AAFD) comprises a wide spectrum of ligament and tendon failure that may result in significant deformity and disability. It is often associated with posterior tibial tendon deficiency (PTTD), which has been linked to multiple demographic factors, medical comorbidities, and genetic processes. AAFD is classified using stages I through IV. Nonoperative treatment modalities should always be attempted first and often provide resolution in stages I and II. Stage II, consisting of a wide range of flexible deformities, is typically treated operatively with a combination of soft tissue procedures and osteotomies. Stage III, which is characterized by a rigid flatfoot, typically warrants triple arthrodesis. Stage IV, where the flatfoot deformity involves the ankle joint, is treated with ankle arthrodesis or ankle arthroplasty with or without deltoid ligament reconstruction along with procedures to restore alignment of the foot. There is limited evidence as to the optimal procedure; thus, the surgical indications and techniques continue to be researched.

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“…Radiographs can be normal, although MRI may show PTT inflammation or early signs of degeneration. 49…”

Section: Stage Imentioning

confidence: 99%

“…Possible soft tissue procedures include tenosynovectomy, PTT repair, and tendon transfer. 49,90,112 Some surgeons believe that soft tissue procedures alone are insufficient and also recommend the addition of a medial calcaneal osteotomy, but this has not been studied for cases without deformity.…”

Section: Ptt Insufficiencymentioning

confidence: 99%

Adult-Acquired Flatfoot Deformity

Henry

Shakked

Ellis

2019

Foot & Ankle Orthopaedics

142

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“…Bulstra et al (18) reported a symptomatic improvement with early mobilization of the joint in a series of 17 patients, of whom 2 required a second endoscopic intervention due to symptom relapse caused by adhesions that did not lead to progression of tibial dysfunction. Gianakos et al (19) also reported relapse of symptoms, but with no evidence of progression of tendon dysfunction. In our series, only one patient complained of persistent pain that lasted for 3 months and was resolved after physical therapy.…”

Section: Discussionmentioning

confidence: 97%

Tendoscopic management of posterior tibial tendinitis

Auellar-Avaroma

King-Martínez

2020

J Foot Ankle

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Objective: The aim of this study was to present a case series of patients undergoing posterior tibial tendoscopy, assess their clinical outcome, and describe surgical findings and treatment complications. Methods: This is a clinical, retrospective, observational study of 11 consecutive cases of tenosynovitis of the posterior tibial tendon. All 11 patients underwent tendoscopy of the posterior tibial tendon. All procedures were performed by the same surgeon in 2 different hospitals. Minimum follow-up was 2 years. Results: All patients had their preoperative and postoperative AOFAS and VAS scores assessed. Both scores had an important improvement at 12 months that persisted at 24 months. Moreover, 72.72% of the patients were very satisfied with the procedure, and no patient reported to be dissatisfied. Additionally, 90.91% of the patients had no postoperative complications. The present results are consistent with those previously reported in the literature. Conclusion: Endoscopic or tendoscopic repair of the posterior tibial tendon is a simple and reproducible procedure that provides good functional and cosmetic outcomes with a low complication rate. It is important to increase the number of patients in this series in order to expand our conclusions. Level of Evidence IV; Therapeutic Studies; Case Series.

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“…Furthermore, PTT tenography and local anaesthetic tendon sheath injections were described as reliable diagnostic tools (Cooper et al 2007; Jaffee et al 2001). Recently, the use of tendoscopy has yielded diagnostic advantages for early recognition of PTT dysfunction (Gianakos et al 2015). …”

Section: Discussionmentioning

confidence: 99%

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

et al. 2016

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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.

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Functional Outcomes of Tibialis Posterior Tendoscopy With Comparison to Magnetic Resonance Imaging

Abstract: Level IV case series.

Cited by 23 publications

References 22 publications

Adult-Acquired Flatfoot Deformity

Adult-Acquired Flatfoot Deformity

Tendoscopic management of posterior tibial tendinitis

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

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