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. 2024 Jun;17(2):e12033.
doi: 10.1002/jfa2.12033.

Non-surgical management of posterior tibial tendon dysfunction- a UK survey

Alison Miller  1   2 , Toby Smith  2 , Michael R Backhouse  2
Affiliations

Non-surgical management of posterior tibial tendon dysfunction- a UK survey

Alison Miller et al. J Foot Ankle Res. 2024 Jun.

Abstract

Background: Posterior Tibial Tendon Dysfunction (PTTD) is commonly seen within musculoskeletal care. The condition's prevalence and management is poorly understood. This study aims to demonstrate current practice by multi-professional clinicians across the United Kingdom within the National Health Service.

Methods: A national (UK) cross-sectional online survey was conducted among multi-professionals who treat PTTD within their NHS practice. The survey covered assessment, management and evaluation. This was shared via social media and professional groups.

Results: Two hundred thirteen surveys were completed, with 153 matching the eligibility criteria. The main respondents were Physiotherapists (48%) and Podiatrists (38%). Ultrasound scanning was used most frequently when considering initial imaging (67%). Many different treatment modalities were used, but a core set of education/advice, foot orthoses, and foot specific as well as general exercise were most commonly chosen. Outcome measures routinely used were pain scale (96/269) and single leg heel raise (84/269), but patient reported outcome measures were not routinely used. The most frequent reason to escalate care was failure to manage symptoms with conservative management (106/123; 86.2%), followed by fixed deformity (10/123; 8.2%).

Conclusions: This survey provides evidence on current non-surgical management for PTTD from UK NHS practice. It provides a valuable marker for clinicians to use to compare their own practice and can be used in further research as a comparator.

Keywords: PTTD; flatfoot; national survey; posterior tibial tendon dysfunction; tibialis posterior.

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Conflict of interest statement

No author declares a conflict of interest in relation to this paper.

Figures

FIGURE 1
FIGURE 1
Pie chart demonstrating the estimated number of people seen by each clinician with PTTD per year. PTTD, posterior tibial tendon dysfunction.
FIGURE 2
FIGURE 2
Bar chart demonstrating the initial imaging modality chosen.
FIGURE 3
FIGURE 3
Bar chart demonstrating the reasons to image given by respondents.
FIGURE 4
FIGURE 4
Bar chart demonstrating treatment modalities chosen.
FIGURE 5
FIGURE 5
Bar chart demonstrating how often treatment modalities are used.
FIGURE 6
FIGURE 6
Demonstrates the use of the most common treatment modalities by Podiatrists and Physiotherapist.
FIGURE 7
FIGURE 7
Bar chart to demonstrate the comparison between Physiotherapists and Podiatrists on foot exercise prescription.
FIGURE 8
FIGURE 8
Bar chart to demonstrate the comparison between Physiotherapists and Podiatrists on general exercise prescription.
FIGURE 9
FIGURE 9
Bar chart demonstrating which outcome measures are regularly used.
FIGURE 10
FIGURE 10
Bar chart demonstrating the reason given for onward referral.
See this image and copyright information in PMC

References

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