Operative Management of Distal Tibialis Anterior Tendinopathy

GRUNDY, J; O’Sullivan, Richard; Beischer, Andrew D.

doi:10.3113/fai.2010.0212

Cited by 34 publications

(42 citation statements)

References 24 publications

(28 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…When compared to other tendinopathies in the ankle, for example involving the tibialis posterior or Achilles tendons, distal tendinopathy of the TAT is little reported in the literature and often little known about [23–25]. This is seen predominantly in overweight women of 50–70 years.…”

Section: Pathologymentioning

confidence: 99%

Ultrasound of tibialis anterior muscle and tendon: anatomy, technique of examination, normal and pathologic appearance

Varghese

Bianchi²

2013

J Ultrasound

View full text Add to dashboard Cite

Lesions of the tibialis anterior muscle and tendon are not frequently reported in international literature although pathology is not rare. Pathology can be spontaneous, associated with arthropathy or more generalized conditions. Clinical assessment may not be sufficient for distinguishing conditions like tendinopathy, tears, bursitis, etc. Therefore, imaging studies are necessary to plan appropriate therapy. US has a number of advantages, including widespread availability, absence of contraindications and low cost. It can also be used for dynamic studies of the muscle during contraction and relaxation. This article reviews the anatomy of the tibialis anterior, normal variants, the technique used for standard US examination of this muscle and tendon, its normal appearance on US and the sonographic characteristics of the most common lesions that affect it including tips on US-guided injections used for treatment.

show abstract

Section: Pathologymentioning

confidence: 99%

Ultrasound of tibialis anterior muscle and tendon: anatomy, technique of examination, normal and pathologic appearance

Varghese

Bianchi²

2013

J Ultrasound

View full text Add to dashboard Cite

show abstract

“…Following debridement, the tendinous insertion remained intact and the longitudinal split tear was repaired in a side-to-side fashion with absorbable polydioxanone (PDS) suture, analogous to repair of longitudinal split tears in other cases of tendinopathy including the supraspinatus, tibialis anterior and peroneal tendons. [212223] Repair was accomplished using the spectrum (Linvatec, Largo, FL) medium-sized crescent hook passed through the two sides of the split tear of the subscapularis tendon [Figure 1a]. We attempted to pass the crescent hook to a depth of roughly 5 mm on each side of the split tear to create a uniform repair, which prevents tissue bunching and limits capturing of the MGHL.…”

Section: Methodsmentioning

confidence: 99%

Non-insertional tendinopathy of the subscapularis

Dierckman

Shah

LaRose

et al. 2013

Int J Shoulder Surg

View full text Add to dashboard Cite

Purpose:(1) Describe a previously unreported finding involving the intra-articular portion of the subscapularis, the Conrad lesion. (2) Describe a novel classification system for the spectrum of non-insertional tendinopathy of the subscapularis. (3) Report the outcomes of surgical treatment of this spectrum of pathology.Materials and Methods:Outcomes of 34 patients (23 males and 11 females, mean age 60.5 ± 7.5) with non-insertional tendinopathy of the subscapularis treated arthroscopically were retrospectively reviewed. All patients had anterior shoulder pain with no weakness during belly-press testing and no subscapularis footprint involvement on magnetic resonance imaging. All patients were managed with subscapularis tendon debridement and side-to-side repair along with treatment of concomitant pathology.Results:Seven patients had a Type I lesion (so-called Conrad lesion) – a nodule on the leading edge of the subscapularis. Eighteen patients had a Type II lesion – a visible split tear with degeneration in the upper ½ of the intra-articular tendon. Nine patients had a Type III lesion – more extensive splitting in the tendon with advanced tendon degeneration. At a mean follow-up of 24 months, 97% of patients were completely satisfied. Significant improvements were seen in forward elevation (152 ± 12° to 172 ± 5°, P < 0.001) and visual analog scale pain scores (5.9 ± 1.7-0.6 ± 1.0, P < 0.001). Internal rotation strength and external rotation motion at the side were maintained. ASES scores averaged 95.4 ± 7.4, disabilities of arm, shoulder and hand scores averaged 6.19 ± 9.8, Western Ontario Rotator Cuff scores averaged 91.7 ± 9.3 and the average University of California at Los Angeles score was 33.1 ± 2.4.Conclusions:We present a previously unreported finding of the subscapularis, the Conrad lesion, along with a novel classification system for non-insertional tendinopathy of the subscapularis. Arthroscopic treatment of this spectrum of tendinopathy along with concomitant shoulder pathology eliminated pain and improved patient outcomes without detrimental effects.Level of Evidence:IV, Retrospective Case Series.

show abstract

“…3 Magnetic resonance imaging (MRI) findings of DTAT include tendon thickening, synovitis, peritendon edema, and possible longitudinal tears as well as abnormal signal in the distal tendon insertion. 7,8 Initial treatment for DTAT is nonoperative, including nonsteroidal anti-inflammatories, physical therapy, a full length orthosis that supports the medial longitudinal arch, and night splints. 7 Surgery may be considered for patients who have failed an extensive trial of nonoperative modalities.…”

Section: Introductionmentioning

confidence: 99%