scholarly journals Tendoscopic treatment of acute posterior tibial tendon dysfunction: case report

2021 ◽  
Vol 15 (3) ◽  
pp. 265-268
Author(s):  
Daniel Saraiva ◽  
Markus Knupp ◽  
André Sá Rodrigues ◽  
Tiago Mota Gomes ◽  
Xavier Martin Oliva
Keyword(s):  
Posterior Tibial Tendon ◽  
Foot And Ankle ◽  
Posterior Tibial Tendon Dysfunction ◽  
Level Of Evidence ◽  
Hindfoot Alignment ◽  
Rheumatoid Patient ◽  
Posterior Tibial ◽  
Foot Arch ◽  
Magnetic Resonance Imaging Mri

We present a case of a rheumatoid patient presenting with acute signs of posterior tibial tendon dysfunction (PTTD). Magnetic resonance imaging (MRI) results were inconclusive regarding the grade of posterior tibial tendon (PTT) tear. We performed posterior tibial tendoscopy, releasing all tendon adherences, and accomplished complete synovectomy. By the end of the procedure, we observed PTT integrity, normal excursion, and mild tendinosis. At 24-month follow-up, the Visual Analog Scale for pain (VAS-Pain) decreased from 9 (preoperatively) to 1. The Foot and Ankle Outcome Score (FAOS) increased from 16% (preoperatively) to 94%. Clinically, the patient had a symmetric bilateral heel rise test and no pain over the course of the PTT. A standard radiographic assessment demonstrated a normal foot arch and hindfoot alignment. This report illustrates how posterior tibial tendoscopy can simultaneously provide accurate diagnosis and surgically address acute PTTD on a rheumatoid patient, relieving symptoms and improving midterm clinical scores. Level of Evidence V; Therapeutic Studies; Expert Opinion.

Subtalar Arthroereisis for Posterior Tibial Tendon Dysfunction: A Preliminary Report

2003 ◽  
Vol 24 (8) ◽  
pp. 600-606 ◽  
Author(s):  
Ramón Viladot ◽  
Miquel Pons ◽  
Fernando Alvarez ◽  
Jorge Omaña
Keyword(s):  
Tendon Repair ◽  
Stage Ii ◽  
Posterior Tibial Tendon ◽  
Foot And Ankle ◽  
Posterior Tibial Tendon Dysfunction ◽  
Posterior Tibial ◽  
Important Improvement ◽  
Sinus Tarsi ◽  
Subtalar Arthroereisis

Background: The purpose of this study was to evaluate preliminary results with Kalix® subtalar arthroereisis in sinus tarsi for stage II posterior tibial tendon dysfunction. Methods: Twenty-one patients with stage II posterior tibial dysfunction, according to Johnson and Storm, underwent surgical treatment between July 1999 and December 2000. All patients were evaluated clinically using the America Orthopaedic Foot and Ankle Society (AOFAS) hindfoot-ankle score. We performed a tendon repair depending on the type and location of the injury and implanted a Kalix® endorthesis in the sinus tarsi. Results: Nineteen patients attended for clinical review with an average follow-up of 27.31 months (range, 19–36). AOFAS scale improved from a preoperative average of 47.2 to an average of 81.6 at revision. The most important improvement was observed in pain (16.3 preoperative to 31.6 postoperative). Two cases required removal of the endorthesis for pain, probably because the endorthesis was too big, without any loss of correction. Patient satisfaction was “satisfied” or “very satisfied” in 17/19. All except three patients would have elected to undergo the same procedure. Conclusions: Subtalar arthroereisis by means of implantation of a Kalix® endorthesis in the sinus tarsi, with prior correction of the deformity and tendon repair, offers an alternative to bone operations such as calcaneal osteotomies, lengthening the external column, or arthodesis in patients with stage II posterior tibial dysfunction.

scholarly journals Can patients affected by stage II Posterior Tibial Tendon Dysfunction return to sport activities after surgical treatment?

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0003
Author(s):  
Federico Giuseppe Usuelli ◽  
Claudia Di Silvestri ◽  
Riccardo D’Ambrosi ◽  
Camilla Maccario ◽  
Eric Tan
Keyword(s):  
Stage Ii ◽  
Posterior Tibial Tendon ◽  
Foot And Ankle ◽  
Flexor Digitorum Longus ◽  
Posterior Tibial Tendon Dysfunction ◽  
Posterior Tibial ◽  
Calcaneal Osteotomy ◽  
Sport Activities ◽  
Flexor Digitorum

Category: Hindfoot, Sports Introduction/Purpose: Medial displacement calcaneal osteotomy with flexor digitorum longus transfer is considered the gold standard in treatment of adult flatfoot associated with posterior tibial tendon dysfunction (stage II in Myerson classification). The aim of this study was to estimate if patients underwent medial displacement calcaneal osteotomy with flexor digitorum longus transfer can participate to sport activities. Methods: 48 patients (21 men, 43,75%; 27 women, 56,25%) with a mean age at time of surgery of 42,3 years (range 19-74 years) were evaluated with a medium follow-up of 30 months (range, 27-34 months). All patients were evaluated clinically and by imaging before and after surgery. The clinical evaluation included for each patient the self-filling of Sports Athlete Foot and Ankle Score (SAFAS). and Pre- and postoperative sporting activities were recorded. The imaging evaluation included a pre-operative foot and ankle MRI and weight-bearing radiographs (antero-posterior, lateral and Saltzman 20° views) of the foot and ankle before surgery and at final follow-up. Moreover, each patients’ pre- and post-operative sport activities were recorded. Results: Preoperatively, 29 of 48 (60,4%) patients were engaged in athletic activities, participating in an average of 1.4 hours/week (range, 0-6 hours/week); postoperatively, 40/48 (83.3%) participated in sport and recreational activities for an average of 3.5 hours/week (range, 0-15 hours/week). Meary’s angle improved significantly from 11.3±6.3 degrees preoperatively to 7.2±5.5 degrees at final-follow-up (p<0.01); calcaneal pitch improved significantly from 16.1±4.3 degrees to 19.4±4.8 degrees (p<0.01). At final follow-up, patients demonstrated good SAFAS scores in symptom tolerance (85.90%), pain tolerance (88.30%), daily living performance (96.2%) and sports performance (86.45%). Conclusion: Most of patients returned or resumed to participate to sport activities after medial displacement calcaneal osteotomy and flexor digitorum longus transfer for the treatment of adult flatfoot associated with posterior tibial tendon dysfunction and the increase of the average number of activities for patient and of the mid time spent was observed.

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.

Subtalar Arthroeresis in Posterior Tibial Tendon Dysfunction

2011 ◽  
Vol 18 (1) ◽  
pp. 55-59
Author(s):  
Sargon Konstantinovich Tamoev ◽  
N V Zagorodniy ◽  
V G Protsko ◽  
E M Sultanov ◽  
Z Kh Khamokov ◽  
...  
Keyword(s):  
Posterior Tibial Tendon ◽  
Foot And Ankle ◽  
Posterior Tibial Tendon Dysfunction ◽  
Flat Foot ◽  
X Ray ◽  
Posterior Tibial ◽  
Study Results ◽  
Foot Function ◽  
American Orthopaedic ◽  
Foot Position

The purpose of the study was to evaluate the efficacy of subtalar arthroeresis for II stage tibial tendon dysfunction by Johnson and Storm classification. From November 2007 to August 2009, 18 patients with that pathology were operated on. After implantation of Kalix® II endorthesis the plasty of posterior tibial tendon was performed. The results were assessed by American Orthopaedic Foot and Ankle Society (AOFAS) scores system. After treatment average estimate by AOFAS increased from 47.2 before operation to 79.0 after surgery, pain index from 16.3 to 30.0, foot function from 28.7 to 41.6, foot position from 2.6 to 8.4. According to X-ray data the longitudinal arch angle decreased by 14.3° at an average and talar-calcaneal angle by 8°. Study results showed that technique of subtalar arthrodesis was effective enough for correction of flat foot resulted from II stage posterior tibial tendon dysfunction. Combination of that technique with tendon plasty ensured the full-value reconstruction of the foot.

Bending, Torsional, and Pullout Strength of Compression Screws in Cadaver Foot and Ankle Specimens

2008 ◽  
Author(s):  
Ferris M. Pfeiffer ◽  
Paul S. Shurnas ◽  
Dennis L. Abernathie ◽  
James A. Ronan
Keyword(s):  
Bone Healing ◽  
Posterior Tibial Tendon ◽  
Foot And Ankle ◽  
Pullout Strength ◽  
Posterior Tibial Tendon Dysfunction ◽  
Bone Screw ◽  
Charcot Neuroarthropathy ◽  
Posterior Tibial ◽  
Small Bones ◽  
The Stability

It has been well supported in the literature that using compression screws is the preferred method to achieve fixation of an arthrodesis [1, 2]. Indications for isolated subtalar arthrodesis include trauma, arthritis, talocalcaneal coalition, adult acquired flatfoot, posterior tibial tendon dysfunction, and Charcot neuroarthropathy [3, 4]. With the increase in bone screw shapes and designs, there is a desire to achieve the best compression generated by a type of screw so as to promote excellent bone healing and outcome for the patient; this will also allow the stability of the construct achieved by the screw and its placement to be determined. As indicated by Wheeler, et. al.[5] screw choice, compression, stability and loading can be very important when it comes to healing of fractures in small bones.

scholarly journals Tendoscopic management of posterior tibial tendinitis

2020 ◽  
Vol 14 (2) ◽  
pp. 168-172
Author(s):  
Alberto Auellar-Avaroma ◽  
Ana Cristina King-Martinez
Keyword(s):  
Case Series ◽  
Posterior Tibial Tendon ◽  
Level Of Evidence ◽  
Posterior Tibial ◽  
Important Improvement ◽  
Number Of Patients ◽  
Patient Reported ◽  
Vas Scores ◽  
Cosmetic Outcomes

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.

scholarly journals Late Presentation of a Retained Stingray Spine in the Plantar Medial Hindfoot

2019 ◽  
Vol 4 (3) ◽  
pp. 247301141986402
Author(s):  
David P. Falk ◽  
Sreenivasulu Metikala ◽  
Viviana Serra Lopez ◽  
Matthew Stein ◽  
Karim Mahmoud ◽  
...  
Keyword(s):  
The United States ◽  
Late Presentation ◽  
Tarsal Tunnel ◽  
Delayed Presentation ◽  
Foot And Ankle ◽  
Level Of Evidence ◽  
Acute Injuries ◽  
Operative Exploration ◽  
Magnetic Resonance Imaging Mri

In the United States, approximately 2000 stingray injuries occur annually. The majority of reports on stingray injuries to the foot and ankle reflect acute injuries. Delayed presentation after stingray injury to the foot and ankle has not been reported. We present a case of a 29-year-old female who sustained a stingray injury to the left plantar medial hindfoot 14 months prior to presenting to our clinic with new-onset posteromedial ankle redness and swelling along the tarsal tunnel. Magnetic resonance imaging (MRI) revealed multiple linear foreign bodies at the quadratus plantae and tarsal tunnel. The patient underwent operative exploration with removal of multiple retained stingray spines. At her most recent follow-up at 3 months, she was able to resume her usual activities. Level of Evidence: Level V, case report.

Nonoperative Management of Posterior Tibial Tendon Dysfunction

1996 ◽  
Vol 17 (12) ◽  
pp. 736-741 ◽  
Author(s):  
Wen Chao ◽  
Keith L. Wapner ◽  
Thomas H. Lee ◽  
Jeffrey Adams ◽  
Paul J. Hecht
Keyword(s):  
Surgical Treatment ◽  
Nonoperative Management ◽  
University Of California ◽  
Posterior Tibial Tendon ◽  
Foot Orthoses ◽  
Posterior Tibial Tendon Dysfunction ◽  
Posterior Tibial ◽  
Ankle Foot Orthoses ◽  
Shoe Inserts

Forty-nine patients with posterior tibial tendon dysfunction (4 patients had bilateral involvement) were treated with orthoses. Forty feet were treated with molded ankle-foot orthoses, and 13 feet were treated with University of California Biomechanics Laboratory shoe inserts with medial posting. A total of 37 women and 12 men were included in the study. The mean follow-up period was 20.3 months (range, 8–60 months). The average age of the patients was 66 years (range, 42–89 years). Sixty-seven percent of patients had good to excellent results, according to a functional scoring system based on pain, function, use of assistive device, distance of ambulation, and patient satisfaction. The average period of orthosis use was 14.9 months (range, 1.5–29 months), with an average length of daily orthosis wear of 12.3 hours. One patient elected to undergo surgical treatment rather than continuing with long-term orthosis use. Thirty-three percent of patients had discountinued using the orthosis at the time of follow-up evaluation. Three patients were unable to wear the orthosis because of concurrent medical conditions. Nine patients stopped wearing the orthosis after experiencing discomfort and inconvenience. Although these patients continued to exhibit signs and symptoms of posterior tibial tendon dysfunction, they were not disabled enough to consider further treatment. Four patients tolerated orthosis treatment poorly and were treated surgically. Patients with posterior tibial tendon dysfunction can be treated by aggressive nonoperative management using molded ankle-foot orthoses or University of California Biomechanics Laboratory shoe inserts with medial posting. Surgical treatment can be reserved for patients who fail to respond to an adequate trial of brace treatment. Nonoperative management using an orthosis is particularly useful for elderly patients with a sedentary lifestyle or for patients at high risk because of medical problems.

Sign in / Sign up

Export Citation Format

Share Document