Long-term follow-up of patients undergoing tibialis posterior transfer: Is acquired pes planus a complication?

Pecheva, Mira; Devany, Adam; Nourallah, Basil; Cutts, Steven; Pasapula, Chandra

doi:10.1016/j.foot.2017.11.008

Cited by 16 publications

(6 citation statements)

References 14 publications

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“…It erroneously assumed that primary synovitis/tears of the tibialis posterior (TP) tendon (Johnson stage 1) were causal rather than reactive, resulting in weakening of the medial arch, progressive collapse (Johnson stage 2), and fixed deformity (Johnson stage 3) [1]. Clinical, cadaver, and computational modelling studies demonstrate that TP subtraction does not necessarily result in progression to unstable planovalgus (in AAFD/PCFD) [12][13][14][15][16][17]. Finite element foot modelling demonstrates peroneal longus (PL) and TP tendon overload with simulated spring ligament (SL) laxity, reinforcing that tendon pain is most likely reactive and not causal.…”

Section: A Critical Review Of Classificationsmentioning

confidence: 99%

“…More planus feet destabilize/collapse, given their biomechanical disadvantage [18]. Asymptomatic feet can start with normal, planus, or cavus attitude and varying degrees of intrinsic stability [17]. Scenarios with less deformity expression include collapsing cavus feet and feet with a neutral foot attitude with SL laxity and first ray stability (early stages).…”

Section: Foot Type and Potential Differential Behaviour Of Cavus Feetmentioning

confidence: 99%

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Review of Classification Systems for Adult Acquired Flatfoot Deformity/Progressive Collapsing Foot Deformity and the Novel Development of the Triple Classification Delinking Instability/Deformity/Reactivity and Foot Type

Pasapula,

Choudkhuri,

Monzó

et al. 2024

JCM

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Background: Classifications of AAFD/PCFD have evolved with an increased understanding of the pathology involved. A review of classification systems helps identify deficiencies and respective contributions to the evolution in understanding the classification of AAFD/PCFD. Methods: Using multiple electronic database searches (Medline, PubMed) and Google search, original papers classifying AAFD/PCFD were identified. Nine original papers were identified that met the inclusion criteria. Results: Johnson’s original classification and multiple variants provided a significant leap in understanding and communicating the pathology but remained tibialis posterior tendon-focused. Drawbacks of these classifications include the implication of causality, linearity of progression through stages, an oversimplification of stage 2 deformity, and a failure to understand that multiple tendons react, not just tibialis posterior. Later classifications, such as the PCFD classification, are deformity-centric. Early ligament laxity/instability in normal attitude feet and all stages of cavus feet can present with pain and instability with minor/no deformity. These may not be captured in deformity-based classifications. The authors developed the ‘Triple Classification’ (TC) understanding that primary pathology is a progressive ligament failure/laxity that presents as tendon reactivity, deformity, and painful impingement, variably manifested depending on starting foot morphology. In this classification, starting foot morphology is typed, ligament laxities are staged, and deformity is zoned. Conclusions: This review has used identified deficiencies within classification systems for AAFD/PCFD to delink ligament laxity, deformity, and foot type and develop the ‘Triple classification’. Advantages of the TC may include representing foot types with no deformity, defining complex secondary instabilities, delinking foot types, tendon reactivity/ligament instability, and deformity to represent these independently in a new classification system. Level of Evidence: Level V.

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Section: A Critical Review Of Classificationsmentioning

confidence: 99%

Section: Foot Type and Potential Differential Behaviour Of Cavus Feetmentioning

confidence: 99%

Review of Classification Systems for Adult Acquired Flatfoot Deformity/Progressive Collapsing Foot Deformity and the Novel Development of the Triple Classification Delinking Instability/Deformity/Reactivity and Foot Type

Pasapula,

Choudkhuri,

Monzó

et al. 2024

JCM

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“…Harvest of the PT may contribute to creation of a pes planovalgus foot deformity because the tibialis posterior also functions as a foot supinator and supports the medial longitudinal arch of the foot. 28,29 This is less likely in the setting of a common peroneal injury with loss of peroneal eversion Illustration showing the tenodesis created by the Bridle procedure creating balanced coronal plane dorsiflexion. The PT tendon has been transferred into a bone tunnel on the medial cuneiform bone.…”

Section: Tendon Transfermentioning

confidence: 99%

“…Harvest of the PT may contribute to creation of a pes planovalgus foot deformity because the tibialis posterior also functions as a foot supinator and supports the medial longitudinal arch of the foot. 28,29 This is less likely in the setting of a common peroneal injury with loss of peroneal eversion strength. These limitations have prompted investigators to search for an alternative treatment to tendon transfer in restoring active ankle dorsiflexion.…”

Section: Tendon Transfermentioning

confidence: 99%

Evaluation and Management of Adult Footdrop

Haupt

Chan

Michalski

et al. 2022

J Am Acad Orthop Surg

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Footdrop is a common musculoskeletal condition defined by weakness in ankle joint dorsiflexion. Although the etiology varies, footdrop is characterized by specific clinical and gait abnormalities used by the patient to overcome the loss of active ankle dorsiflexion. The condition is often associated with deformity because soft-tissue structures may become contracted if not addressed. Patients may require the use of special braces or need surgical treatment to address the notable level of physical dysfunction. Surgical treatment involving deformity correction to recreate a plantigrade foot along with tendon transfers has been used with notable success to restore a near-normal gait. However, limitations and postoperative dorsiflexion weakness have prompted investigation in nerve transfer as a possible alternative surgical treatment.

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“…Flat feet (FF), also known as pes planus, are one of the most prevalent foot abnormality in adults, characterized by decreased medial longitudinal arch height and the dorsiflexed and abducted forefoot 1 . FF are caused by a wide variety of factors including body composition 2 , foot intrinsic and extrinsic muscle weakness 3 , foot and ankle injuries 4 , hereditary features 5 , iatrogenic variables 6 , pregnancy 7 , and neurological problems 8 . On the other hand, FF could lead to insufficient foot function such as failure in body weight support or alteration in force distribution 9 , and it is associated with foot pathological conditions such as metatarsalgia 10 or plantar fasciitis 11 as well as Achilles tendinopathy 12 .…”

mentioning

confidence: 99%

The Immediate Effect of Cumulative Transverse Strain via Exercise on the Achilles Tendon in Individuals with and Without Flat Feet

Taş,

Koçyiğit,

Aracı

et al. 2023

Journal of the American Podiatric Medical Association

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Background: Flat feet change lower extremity alignment, and it may change the load distribution on Achilles tendon during exercise. The purpose of the present study was to investigate the immediate effect of cumulative transverse strain via resistive ankle plantarflexion exercise on the Achilles tendon in individuals with flat feet. Methods: Fourteen individuals with flat feet and 14 age-matched individuals with normal foot posture were enrolled in the present study. Achilles tendon thickness was measured by an ultrasonography device with a linear probe at 3 points: 1 cm (AT-1), 2 cm (AT-2), and 3 cm (AT-3) proximal to the superior aspect of the calcaneus. Ultrasonography measurements were performed before and after participants completed 90 repetitions of double-leg calf raise exercises which included moving the foot from full ankle dorsiflexion to full ankle plantarflexion. Results: Achilles tendon thickness at all points measured was thinner in the flat feet group at both pre- and post-exercise conditions compared with that of the control group (p<0.05). Achilles tendon thickness at AT-1, AT-2, and AT-3 decreased after the exercise in both groups (p<0.001). The differences in Achilles tendon thickness at all points measured between pre- and post-exercise conditions were lower in individuals with flat feet than those of the control group (p<0.05). Conclusion: There was a significant decrease in Achilles tendon thickness after exercise in both groups; however, the tendon thickness markedly diminished in individuals with normal foot posture. The results are thought to result from changes in tendon structure and in load distribution on the Achilles tendon.

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Long-term follow-up of patients undergoing tibialis posterior transfer: Is acquired pes planus a complication?

Cited by 16 publications

References 14 publications

Review of Classification Systems for Adult Acquired Flatfoot Deformity/Progressive Collapsing Foot Deformity and the Novel Development of the Triple Classification Delinking Instability/Deformity/Reactivity and Foot Type

Review of Classification Systems for Adult Acquired Flatfoot Deformity/Progressive Collapsing Foot Deformity and the Novel Development of the Triple Classification Delinking Instability/Deformity/Reactivity and Foot Type

Evaluation and Management of Adult Footdrop

The Immediate Effect of Cumulative Transverse Strain via Exercise on the Achilles Tendon in Individuals with and Without Flat Feet

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