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. 2006 Sep;2(2):157-60.
doi: 10.1007/s11420-006-9017-0.

Posterior tibial tendon insufficiency results at different stages

Jonathan T Deland  1 , Alexandra Page, Il-Hoon Sung, Martin J O'Malley, David Inda, Steven Choung
Affiliations

Posterior tibial tendon insufficiency results at different stages

Jonathan T Deland et al. HSS J. 2006 Sep.

Abstract

The results of surgical treatment of posterior tibial tendon insufficiency (PTTI) may be different at different stages of the disease. No single study has compared the results at different stages. This comparison can be helpful to the patient and physician if the patient asks "What if I wait and the disease progresses, how will my results be different?" A preliminary study comparing results for stage IIa, stage IIb (advanced stage II), and stage III was performed followed by a larger study comparing IIa and IIb with 26 and 22 patients, respectively. American Orthopaedic Foot and Ankle Society (AOFAS) outcome scores as well as radiographs and functional questions were used. Nearly all patients, regardless of stage, felt they were helped by surgical treatment. However, the lowest AOFAS score was in stage III, the most advanced stage investigated in this study. In comparing stage IIa and IIb patients, stage IIb patients had a statistically higher incidence of lateral discomfort. Although statistically significant differences were not found in all comparisons, this study suggests that the results of surgical treatment for PTTI declines with increasing stage or severity of disease.

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Figures

Fig. 1
Fig. 1
AOFAS outcome scores for groups 1–4. Note the lower scores in stage III (group 4) and stage IIb (group 3), which was treated with a calcaneocuboid lengthening arthrodesis
Fig. 2
Fig. 2
Percentage of patients with lateral discomfort in group 1 (stage IIa, treated with a medial slide osteotomy) vs group 2 (stage IIb, treated with a medial slide and lateral column lengthening)
Fig. 3
Fig. 3
Stiffness in Group 1 (MS) vs all Group 2 (MS and LCL) patients
Fig. 4
Fig. 4
Stiffness results comparing lateral column lengthening in patients who had lateral discomfort and those who did not
See this image and copyright information in PMC

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