scholarly journals Preoperative PROMIS Scores as a Predictive Method for Postoperative Success in Posterior Tibial Tendon Dysfunction Surgery

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0031
Author(s):  
Rusheel Nayak ◽  
Milap Patel ◽  
Anish Kadakia
Keyword(s):  
Physical Function ◽  
Regression Models ◽  
Posterior Tibial Tendon ◽  
Posterior Tibial Tendon Dysfunction ◽  
Surgical Success ◽  
Posterior Tibial ◽  
Diabetes Status ◽  
Significant Difference ◽  
Patient Reported ◽  
Average Change

Category: Hindfoot Introduction/Purpose: Patient Reported Outcomes Instrumentation System (PROMIS) pain interference (PI) and physical function (PF) scales were recently validated for foot & ankle surgery. Few studies have explored PROMIS in advanced posterior tibial tendon dysfunction (PTTD) surgery. We examined the change in PROMIS scores after PTTD reconstruction surgery and aimed to determine whether preoperative PROMIS scores, radiographic data, and demographic data can model and predict surgical improvement. Methods: PF and PI scores were prospectively obtained on 215 patients between November 2013 and May 2017. Of the 34 patients who had PTTD surgery, 25 patients were included with a minimum follow-up of 7-months (mean 21.8). Paired t-tests and multivariable linear regression models tested the difference in PROMIS scores pre- to postoperatively. Minimal clinically important differences (MCID) and receiver operator curve (ROC) analysis determined the accuracy of using preoperative scores in predicting postoperative change. The MCID for PROMIS PI and PF was defined as half of its respective standard deviation. Multivariable linear regressions with preoperative PROMIS scores, changes in radiographic imaging, and BMI were created to model change in PROMIS scores. Results: There was a significant difference in pre- to postoperative mean PI PROMIS scores (p = 0.0016, average change = -7.16). Mean PF scores improved postoperatively, but not significantly (p = .0595, average change = +4.17). Improvement in PI remained significant (p= 0.02) after adjusting for significant predictors (education level and diabetes status). Multivariable regression models utilizing preoperative PROMIS scores, radiographic variables, and BMI were unable to predict changes in PF and PI scores (p > 0.05). Using pre-determined MCID criteria, 68% achieved surgical success for PI (defined as change of at least -3.45) and 52% achieved surgical success for PF (defined as change of at least +3.00). However, preoperative PI (p=0.310) and PF (p=0.054) scores were unable to significantly predict MCID surgical success or failure. Conclusion: After major PTTD reconstruction, PI scores improve to significance but PF scores may not. After PTTD reaches an advanced stage, surgery may provide significant pain relief and improvement in physical function and radiographic parameters, but it may be difficult to predict clinical improvement based solely on preoperative PROMIS scores. Realistic expectations of improvements in pain and functionality should be maintained postoperatively in advanced PTTD surgery.

3D foot kinematic difference in Posterior Tibial Tendon Dysfunction stage II/III and control group

2016 ◽  
Vol 22 (2) ◽  
pp. 11
Author(s):  
S. Wuite ◽  
K. Deschamps ◽  
C. Roels ◽  
M. van de Velde ◽  
F. Staes ◽  
...  
Keyword(s):  
Stage Ii ◽  
Control Group ◽  
Posterior Tibial Tendon ◽  
Posterior Tibial Tendon Dysfunction ◽  
Posterior Tibial ◽  
And Control

Foot and ankle functions and deformities focus on posterior tibial tendon dysfunction using magnetic resonance imaging in patients with rheumatoid arthritis

2021 ◽  
Author(s):  
Takeshi Mochizuki ◽  
Yuki Nasu ◽  
Koichiro Yano ◽  
Katsunori Ikari ◽  
Ryo Hiroshima ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Pitch Angle ◽  
Posterior Tibial Tendon ◽  
Foot And Ankle ◽  
Resonance Imaging ◽  
Posterior Tibial Tendon Dysfunction ◽  
First Metatarsal ◽  
Posterior Tibial ◽  
Metatarsal Angle

ABSTRACT Objectives Posterior tibial tendon dysfunction (PTTD) affects the support of the medial longitudinal arch and stability of the hindfoot. The purpose of this study was to assess the relationships of PTTD with foot and ankle functions and foot deformities in patients with rheumatoid arthritis (RA). Methods A total of 129 patients (258 feet) who underwent magnetic plain and contrast-enhanced magnetic resonance imaging were enrolled in this study. Positive magnetic resonance imaging findings were defined as tenosynovitis and incomplete and complete rupture of the posterior tibial tendon. Foot and ankle functions were assessed using the Japanese Society for Surgery of the Foot standard rating system for the RA foot and ankle scale (JSSF-RA) and self-administered foot evaluation questionnaire. Plain radiographs were examined for the hallux valgus angle, first metatarsal and second metatarsal angle, lateral talo-first metatarsal angle, and calcaneal pitch angle. Results PTTD was associated with motion in the JSSF-RA (p = .024), activities of daily living in JSSF-RA (p = .017), and pain and pain-related factors in the self-administered foot evaluation questionnaire (p = .001). The calcaneal pitch angle was significantly lower in the feet with PTTD than in those without PTTD (median: 16.2° vs. 18.0°; p = .007). Conclusions The present study shows that PTTD was associated with foot and ankle functions and flatfoot deformity. Thus, a better understanding of PTTD in patients with RA is important for the management of foot and ankle disorders in clinical practice.

scholarly journals Efek Injeksi Plasma Kaya Platelet Terhadap Tenosinovitis Tendon Tibialis Posterior: Sebuah Studi Kasus

2019 ◽  
Vol 5 (1) ◽  
pp. 60-65
Author(s):  
Henry Ricardo Handoyo ◽  
Andryan Hanafi Bakri ◽  
Andri Primadhi Primadhi
Keyword(s):  
Platelet Rich Plasma ◽  
Tibialis Posterior ◽  
Medial Malleolus ◽  
Posterior Tibial Tendon ◽  
Foot And Ankle ◽  
Posterior Tibial Tendon Dysfunction ◽  
Flat Foot ◽  
Posterior Tibial ◽  
Left Ankle ◽  
History Of

Introduction: Posterior tibial tendon dysfunction is one of the most common, problems of the foot and ankle. Tenosynovitis of the posterior tibial tendon (PTT) is an often unrecognized form of PTT dysfunction. Case: A 54-year-old woman presented with left ankle pain that began while morning walk three days prior. She noted that the left ankle hurt with even light touch and the pain was unrelieved with sodium diclofenac. She denied any history of trauma. She was seen in the outpatient clinic for this condition. On examination, a three centimeter area of pain was found posterior to the medial malleolus and parallel to the PTT. She also had a stage I flat foot and mild soft tissue swelling around medial malleolus region on her radiograph examination. Ultrasound examination was done with the result of anechoic fluid visible in the peritendinous space around the PTT. The patient received diagnosis of PTT tenosynovitis, with the foot and ankle disability index (FADI) score was 58.7. Platelet rich plasma (PRP) injection was done twice with an interlude of two weeks. The pain subsided and the following FADI score was 84.6. Outcome: Patient showed improvement in her left ankle PTT tenosynovitis after two PRP injection. Conclusion: This case report highlights the efficacy of PRP as a modality in managing PTT tenosynovitis.

scholarly journals Performance of the PROMIS in Patients After Anterior Cruciate Ligament Reconstruction

2018 ◽  
Vol 6 (5) ◽  
pp. 232596711877450 ◽  
Author(s):  
Elizabeth J. Scott ◽  
Robert Westermann ◽  
Nathalie A. Glass ◽  
Carolyn Hettrich ◽  
Brian R. Wolf ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Physical Function ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Sf 36 ◽  
Significant Difference ◽  
Patient Reported ◽  
Floor Effects ◽  
Anterior Cruciate ◽  
Pro Instruments

Background: The Patient-Reported Outcomes Measurement Information System (PROMIS) is designed to advance patient-reported outcome (PRO) instruments by utilizing question banks for major health domains. Purpose: To compare the responsiveness and construct validity of the PROMIS physical function computer adaptive test (PF CAT) with current PRO instruments for patients before and up to 2 years after anterior cruciate ligament (ACL) reconstruction. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: Initially, 157 patients completed the PROMIS PF CAT, Short Form–36 Health Survey (SF-36 physical function [PF] and general health [GH]), Marx Activity Rating Scale (MARS), Knee injury and Osteoarthritis Outcome Score (KOOS activities of daily living [ADL], sport, and quality of life [QOL]), and EuroQol–5 dimensions questionnaire (EQ-5D) at 6 weeks, 6 months, and 2 years after ACL reconstruction. Correlations between instruments, ceiling and floor effects, effect sizes (Cohen d), and standardized response means to describe responsiveness were evaluated. Subgroup analyses compared participants with and without additional arthroscopic procedures using linear mixed models. Results: At baseline, 6 weeks, and 6 months, the PROMIS PF CAT showed excellent or excellent-good correlations with the SF-36 PF ( r = 0.75-0.80, P < .01), KOOS-ADL ( r = 0.63-0.70, P < .01), and KOOS-sport ( r = 0.32-0.69, P < .01); excellent-good correlation with the EQ-5D ( r = 0.60-0.71, P < .01); and good correlation with the KOOS-QOL ( r = 0.52-0.58, P < .01). As expected, there were poor correlations with the MARS ( r = 0.00-0.24, P < .01) and SF-36 GH ( r = 0.16-0.34, P < .01 ). At 2 years, the PROMIS PF CAT showed good to excellent correlations with all PRO instruments ( r = 0.42-0.72, P < .01), including the MARS ( r = 0.42, P < .01), indicating frequent return to preinjury function. The PROMIS PF CAT had the fewest ceiling or floor effects of all instruments tested, and patients answered, on average, 4 questions. There was no significant difference in baseline physical function scores between subgroups; at follow-up, all groups showed improvements in scores that were not statistically different. Conclusion: The PROMIS PF CAT is a valid tool to assess outcomes after ACL reconstruction up to 2 years after surgery, demonstrating the highest responsiveness to change with the fewest ceiling and floor effects and a low time burden among all instruments tested. The PROMIS PF CAT is a beneficial alternative for assessing physical function in adults before and after ACL reconstruction.

Biomechanical effects of three types of foot orthoses on a posterior tibial tendon dysfunction population during a stair climbing task

2019 ◽  
Vol 11 (sup1) ◽  
pp. S104-S105
Author(s):  
Dominic Chicoine ◽  
Marc Bouchard ◽  
Samuel Trempe ◽  
Simon Laurendeau ◽  
Etienne L. Belzile ◽  
...  
Keyword(s):  
Stair Climbing ◽  
Posterior Tibial Tendon ◽  
Foot Orthoses ◽  
Posterior Tibial Tendon Dysfunction ◽  
Posterior Tibial
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