scholarly journals Postoperative evaluation of posterior tibial tendon transfer

2018 ◽  
Vol 12 (2) ◽  
pp. 145-149
Author(s):  
Larissa Miranda Xavier Vieira ◽  
Rodrigo Barra Caiado Fleury ◽  
Bruno Severino Nunes ◽  
Jefferson Soares Martins ◽  
Edegmar Nunes Costa
Keyword(s):  
Tendon Transfer ◽  
Case Series ◽  
Interference Screw ◽  
Posterior Tibial Tendon ◽  
Drop Foot ◽  
Level Of Evidence ◽  
Posterior Tibial ◽  
Before And After ◽  
Life Improvement ◽  
Therapeutic Study

Objectives: To analyse and report the advantages of posterior tibial tendon transfer amongst patients with drop-foot as well as evaluate the degrees of foot biomechanical restoration and patient quality of life improvement. Methods: Seven patients diagnosed with drop-foot received surgery in which the posterior tibial tendon was transferred via the syndesmotic membrane, and the tendon was fixed to the lateral cuneiform bone using an interference screw. Results: The patients completed the Stanmore questionnaire before and after surgery to report their improvements with regard to all of the questionnaire criteria.Conclusion: The adopted surgical technique is an effective method of disease correction, with associated pain improvement, resumption of wearing shoes, elimination of the regular use of an ankle-foot orthosis (AFO), muscle strength gain, and functional capacity improvement. Level of Evidence IV; Therapeutic Study; Case Series.

scholarly journals Anterior Tibial Tendon Side-to-Side Tenorrhaphy after Posterior Tibial Tendon Transfer: A Technique to Improve Reliability in Drop Foot after Common Peroneal Nerve Injury

2021 ◽  
Author(s):  
Miguel Estuardo Rodríguez-Argueta ◽  
Carlos Suarez-Ahedo ◽  
César Alejandro Jiménez-Aroche ◽  
Irene Rodríguez-Santamaria ◽  
Francisco Javier Pérez-Jiménez ◽  
...  
Keyword(s):  
Peroneal Nerve ◽  
Tendon Transfer ◽  
Common Peroneal Nerve ◽  
Posterior Tibial Tendon ◽  
Drop Foot ◽  
Posterior Tibial ◽  
Anterior Tibial ◽  
Anterior Tibial Tendon ◽  
Peroneal Nerve Injury ◽  
Improve Reliability

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 A Novel Medial Malleolar Osteotomy Technique for the Treatment of Osteochondral Lesions of the Talus

2021 ◽  
Vol 9 (3) ◽  
pp. 232596712198998
Author(s):  
Yong Hu ◽  
Cheng Yue ◽  
Xiucun Li ◽  
ZhengXun Li ◽  
Dongsheng Zhou ◽  
...  
Keyword(s):  
Case Series ◽  
High Rate ◽  
Osteochondral Lesions ◽  
Medial Malleolus ◽  
Posterior Tibial Tendon ◽  
The Novel ◽  
Level Of Evidence ◽  
Posterior Tibial ◽  
Medial Malleolar Osteotomy ◽  
Osteotomy Technique

Background: The current techniques for medial malleolar osteotomy may lead to posterior tibial tendon injury and have a high rate of malunion. Purpose: To describe a novel partial step-cut medial malleolar osteotomy technique and evaluate its technical feasibility and its advantages compared with traditional methods. Study Design: Case series; Level of evidence, 4. Methods: The novel technique consisted of osteotomy of the anterior one-third to two-thirds of the medial malleolus. A total of 19 ankles (18 patients) with osteochondral lesions of the talus underwent the novel osteotomy technique before osteochondral reconstruction. All patients were evaluated for more than 2 years. Radiographs were analyzed for postoperative displacement and malunion, and postoperative ankle function was evaluated according to the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot scale and the visual analog scale (VAS) for pain. Results: The partial step-cut osteotomy technique was able to provide adequate intra-articular exposure without disturbing the posterior tibial tendon. The 19 ankles healed at a mean of 7.3 ± 1.5 weeks (range, 6-12 weeks). There was slight incongruence in 4 ankles, with a displacement of 1.0 ± 0.1 mm proximally and 0.3 ± 0.1 mm medially. The mean postoperative AOFAS and VAS scores improved compared with preoperatively, from 54.2 ± 12.1 to 84.6 ± 6.6 and from 6.4 ± 1.0 to 1.8 ± 1.3, respectively ( P < .001 for both). No intraoperative tendon injuries were observed. Conclusion: Results indicated that partial step-cut osteotomy is a reliable and effective method for providing enough exposure, avoiding displacement after reduction, and not disturbing the anatomic structures behind the medial malleolus.

Combined Spring and Deltoid Ligament Repair in Adult-Acquired Flatfoot

2018 ◽  
Vol 39 (8) ◽  
pp. 903-907 ◽  
Author(s):  
Caio Nery ◽  
André Vitor Kerber C. Lemos ◽  
Fernando Raduan ◽  
Nacime Salomão B. Mansur ◽  
Daniel Baumfeld
Keyword(s):  
Case Series ◽  
Deltoid Ligament ◽  
Posterior Tibial Tendon ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Posterior Tibial ◽  
Novel Technique ◽  
Spring Ligament ◽  
Tissue Healing ◽  
Internal Brace

Background: Adult-acquired flatfoot deformity (AAFD) is usually due to a combination of mechanical failure of the osteoligamentous complex that maintains the medial longitudinal arch of the foot and attenuation or complete tear of the posterior tibial tendon. Magnetic resonance imaging studies in patients with flatfoot deformities have reported the posterior tibial tendon to be pathologic in up to 100% of patients, the spring ligament in up to 87%, and the deltoid ligament in 33%. Many studies in the literature describe reconstruction of the spring ligament or the deltoid ligament associated with AAFD, but there is no study in which both (spring and deltoid) ligaments are reconstructed at the same time. We describe a novel technique to reconstruct the deltoid ligament and the spring ligament at the same time. Methods: We described the technique and evaluated 10 consecutive patients with AAFD and insufficient ankle and midfoot ligaments. Results: We found no postoperative complications, stiffness, or loss of correction. Conclusion: We present a novel technique to reconstruct the failed deltoid and spring ligament during flatfoot correction. It is unique in that it uses internal brace augmentation with FiberTape® to help and protect the soft tissue healing. Level of Evidence: Level IV, retrospective case series.

scholarly journals Assessment of imaging, pathoanatomy and terminology in posterior tibial tendon dysfunction

2020 ◽  
Vol 14 (2) ◽  
pp. 126-131
Author(s):  
Matthew Workman ◽  
Nick Saragas ◽  
Paulo Ferrao
Keyword(s):  
Case Series ◽  
Tendon Sheath ◽  
Pathological Process ◽  
Preoperative Imaging ◽  
Research Assessment ◽  
Posterior Tibial Tendon ◽  
Posterior Tibial Tendon Dysfunction ◽  
Mri Findings ◽  
Level Of Evidence ◽  
Posterior Tibial

Objective: This study aimed to determine damage/change occurring in the posterior tibial tendon of patients undergoing surgery for posterior tibial tendon dysfunction (PTTD) and to correlate preoperative imaging and intraoperative findings with histology to determine the most appropriate investigations for diagnosis. The secondary aim was to clarify terminology used in describing the tendon pathology, to improve descriptive terminology for research, assessment, and treatment of PTTD. Methods: The records of patients who had undergone surgery for stage 2 PTTD were retrospectively reviewed. Cases in which preoperative diagnostic imaging was done and a posterior tibial tendon specimen was sent for histology were included. Ultrasound (US) and MRI findings, surgical notes and histopathological reports were evaluated. Results: Nineteen patients met the inclusion criteria. Fourteen had US showing degenerative changes and synovitis. Five had MRI showing tendon degeneration, with rupture in two cases. Intraoperatively, all tendons showed gross abnormality, with surrounding synovitis. Microscopically, no acute inflammation was noted within any tendon specimens. All had non-specific reactive changes within the visceral synovium. Conclusion: This study confirms clear histological degeneration within the posterior tibial tendon of patients undergoing corrective surgery for PTTD. Preoperative imaging and surgical findings identified tendon sheath synovitis. Pre-operative ultrasound imaging and intraoperative confirmation of PTTD is accurate; thus, histological confirmation is unnecessary. The pathological changes in PTTD have been described as a tendinopathy in the literature. We suggest using the term pantendinopathy, which is a combination of peritendinitis with tendinosis, as it better describes the pathological process. Level of Evidence IV; Therapeutic Studies; Case Series

Prevalence of Abnormal Ultrasound Findings in Asymptomatic Posterior Tibial Tendons

2020 ◽  
Vol 41 (9) ◽  
pp. 1049-1055
Author(s):  
F. Baker Mills ◽  
Kevin Williams ◽  
Christopher H. Chu ◽  
Paul Bornemann ◽  
J. Benjamin Jackson
Keyword(s):  
Pathological Condition ◽  
Case Series ◽  
Institutional Review Board ◽  
Posterior Tibial Tendon ◽  
Posterior Tibial Tendon Dysfunction ◽  
Level Of Evidence ◽  
Posterior Tibial ◽  
Institutional Review Board Approval ◽  
Institutional Review ◽  
Ultrasound Findings

Background: Posterior tibial tendon dysfunction (PTTD) is a pathological condition that can cause failure of the posterior tibial tendon (PTT). Initially, patients with PTTD are often asymptomatic, making early identification and treatment challenging. Certain ultrasound (US) characteristics have been implicated in the presence of tendinopathy, but their frequency has yet to be assessed in the PTT. The purpose of this study was to identify and report on the frequency of incidental, or potentially early subclinical, tendinopathic US characteristics in asymptomatic PTTs. Methods: Following institutional review board approval, 150 participants underwent a bilateral-comprehensive US assessment. The resulting images were reviewed and assessed to identify the presence of abnormalities demonstrated to represent tendinopathy. Results: Overall, 266 tendons were assessed and 128 (48.1%) were determined to have at least one tendinopathic trait. Specifically, 51 (19.2%) had circumferential fluid, 69 (25.9%) had noncircumferential fluid, 22 (8.3%) had thickening, 31 (11.7%) had heterogenicity, 19 (7.1%) had hyperemia, and 2 (0.8%) had calcification. Additionally, Caucasian participants were found to be nearly 3 times more likely to have tendinopathic findings when compared with African American participants. Conclusion: Sixty-seven percent of participants and 48.1% of PTTs evaluated had at least one tendinopathic feature identified on US. The prevalence rates of these findings, observed in participants, were as follows: noncircumferential fluid, circumferential fluid, heterogenicity, and thickening. Knowing the frequency of these traits may help clinicians to identify subclinical tendinopathy in the PTT before it progresses to PTTD. Level of Evidence: Level IV, case series.

scholarly journals Hallux rigidus

2019 ◽  
Vol 13 (3) ◽  
pp. 191-7
Author(s):  
Mariana Alcântara Roldi de Azeredo ◽  
Joaquim Maluf Neto
Keyword(s):  
Functional Performance ◽  
Case Series ◽  
Cross Sectional Study ◽  
Hallux Rigidus ◽  
Resection Arthroplasty ◽  
Level Of Evidence ◽  
Sports Activity ◽  
Cross Sectional ◽  
Before And After ◽  
Therapeutic Study

Objective: This study evaluated the postoperative outcomes of patients with hallux rigidus who underwent cheilectomy combined with modified Lelièvre resection arthroplasty. Methods: This retrospective cross-sectional study applied the adapted American Orthopedic Foot and Ankle Society (AOFAS) forefoot questionnaire. A total of 28 patients (31 feet with hallux rigidus) were evaluated and treated following the same clinical and surgical protocol between February 2010 and June 2018. We evaluated pain, footwear use, sports activity, surgical complications, and the AOFAS score before and after surgery. Results: All patients who underwent surgery showed improved AOFAS scores and reduced pain with satisfactory functional performance. Conclusions: The use of cheilectomy combined with modified Lelièvre resection arthroplasty was effective, especially with regard to maintaining foot function, significantly improving pain and gait performance, and providing the possibility of wearing ordinary footwear, thereby increasing patient quality of life. This result was consistent with the extant literature on the topic. Level of Evidence IV; Therapeutic Study; Case Series.

Tendon Transfer Combined with Calcaneal Osteotomy for Treatment of Posterior Tibial Tendon Insufficiency: A Radiological Investigation

1995 ◽  
Vol 16 (11) ◽  
pp. 712-718 ◽  
Author(s):  
Mark S. Myerson ◽  
John Corrigan ◽  
Francesca Thompson ◽  
Lew C. Schon
Keyword(s):  
Tendon Transfer ◽  
Posterior Tibial Tendon ◽  
Flexor Digitorum Longus ◽  
First Metatarsal ◽  
Posterior Tibial ◽  
Metatarsal Angle ◽  
Medial Cuneiform ◽  
Before And After ◽  
The Mean ◽  
Flexor Digitorum

We present the radiographic results after flexor digitorum longus tendon transfer combined with a medial displacement calcaneal osteotomy for the treatment of posterior tibial tendon insufficiency. Eighteen patients with posterior tibial tendon insufficiency were reviewed from 12 to 26 months after surgery. The 15 women and 3 men had a mean age of 54 years (range, 38–72 years). The talar-first metatarsal and talonavicular coverage angles were measured before and after surgery on the anteroposterior weightbearing radiographs. The mean preoperative talar-first metatarsal and talonavicular coverage angles were 21° (range, 3–45°) and 34° (range, 0–55°), respectively. The mean postoperative values for these angles were 8.5° (range, 0–35°) and 21° (range, −30–45°), respectively. The mean talar-first metatarsal angle decreased from 21° to 8.5°, a mean improvement of 12.5°, and the mean talonavicular coverage angle decreased from 34° to 21°, a mean improvement of 13°. On the lateral weightbearing radiographs, the talar-first metatarsal angle and the distance from the medial cuneiform to the floor were measured before and after surgery. The mean preoperative values were −22° (range, −10 to −40°) and 9 mm (range, 1–19 mm), respectively. The mean postoperative values were −9° (range, +5 to −25°) and 16 mm (range, 10–28 mm), respectively. The mean talar-first metatarsal angle decreased from −22 to −9° (a mean improvement of 13°), and the distance from the medial cuneiform to the floor increased from 9 to 16 mm (a mean improvement of 7 mm). We conclude that the use of a combined medial displacement osteotomy of the calcaneus with a tendon transfer for treatment of posterior tibial tendon insufficiency may offset the inherent weakness of the flexor digitorum longus transfer by reducing the antagonistic deforming force of heel valgus.

Sign in / Sign up

Export Citation Format

Share Document