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Endoscopic assisted posterior tibial tendon reconstruction for stage 2 posterior tibial tendon insufficiency

  • Ankle
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Posterior tibial tendon insufficiency is the commonest cause of adult onset flatfoot deformity. The treatment of stage 2 posterior tibial tendon insufficiency is still controversial. Different combination of open procedures of tendon transfer, calcaneal osteotomy and hindfoot arthrodesis has been described. We describe an endoscopic approach of posterior tibial tendon reconstruction. By means of anterior and posterior tibial tendon tendoscopies, the medial half of the anterior tibial tendon is then transferred to the posterior tibial tendon. The construct is then augmented by side-to-side anastomosis with flexor digitorum longus tendon. This is supplemented with subtalar arthroereisis with a bioresorbable arthroereisis implant.

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References

  1. Johnson KA, Strom DE (1989) Tibialis posterior tendon dysfunction. Clin Orthop 239:196–206

    PubMed  Google Scholar 

  2. Myerson MS (1996) Adult acquired flatfoot deformity: treatment of dysfunction of the posterior tibial tendon. J Bone Joint Surg Am 78:780–792

    Google Scholar 

  3. Myerson MS, Corrigan J, Thompson F (1995) Tendon transfer combined with calcaneal osteotomy for the treatment of posterior tibial tendon insufficiency: a radiological investigation. Foot Ankle Int 16:712–718

    PubMed  CAS  Google Scholar 

  4. Myerson MS, Corrigan J (1996) Treatment of posterior tibial tendon dysfunction with flexor digitorum longus tendon transfer and calcaneal osteotomy. Orthopedics 19:383–388

    PubMed  CAS  Google Scholar 

  5. Guyton GP, Jeng C, Kreiger LE, Mann RA (2001) Flexor digitorum longus transfer and medial displacement calcaneal osteotomy for posterior tibial tendon dysfunction: a middle term clinical follow-up. Foot Ankle Int 22:627–636

    PubMed  CAS  Google Scholar 

  6. Nyska M, Parks B, Chu I, Myerson M (2001) The contribution of the medial calcaneal osteotomy to the correction of flatfoot deformities. Foot Ankle Int 22:278–282

    PubMed  CAS  Google Scholar 

  7. Sammarco GJ, Hockenbury RT (2001) Treatment of stage II posterior tibial tendon dysfunction with flexor hallucis longus transfer and medial displacement calcaneal osteotomy. Foot Ankle Int 22:305–312

    PubMed  CAS  Google Scholar 

  8. Kitaoka HB, Kura Hideji, Luo ZP, An KN (2000) Calcaneocuboid distraction arthrodesis for posterior tibial tendon dysfunction and flatfoot. Clin Orthop 381:241–247

    Article  PubMed  Google Scholar 

  9. Thomas RL, Wells BC, Garrison RL, Prada SA (2001) Preliminary results comparing two methods of lateral column lengthening. Foot Ankle Int 22:107–119

    PubMed  CAS  Google Scholar 

  10. Johnson JE, Cohen BE, DiGiovanni BF, Lamdan R (2000) Subtalar arthrodesis with flexor digitorum longus transfer and spring ligament repair for treatment of posterior tibial tendon insufficiency. Foot Ankle Int 21:722–729

    PubMed  CAS  Google Scholar 

  11. Silver RL, Garza J, Rang M (1985) The myth of muscle balance: a study of the relative strengths and excursions of normal muscles about the foot and ankle. J Bone Joint Surg Br 67B:432–437

    Google Scholar 

  12. Niek van Dijk C, Kort N, Scholten PE (1997) Tendoscopy of the posterior tibial tendon. Arthroscopy 13(6):692–698

    Google Scholar 

  13. Chow HT, Chan KB, Lui TH (2005) Tendoscopic debridement for stage I posterior tibial tendon dysfunction knee surgery. Sports Traumatol Arthrosc 13(8):695–698

    Article  Google Scholar 

  14. Helal B (1990) Cobb repair for tibialis posterior tendon rupture. J Foot Surg 29:349–352

    PubMed  CAS  Google Scholar 

  15. Cobb N (1996) Tibial posterior tendon disorder. In: Helal B, Rowley DI, Cracchiola A (eds) Surgery of disorders of the foot and ankle. JB Lippincott, Philadelphia, pp 291–301

    Google Scholar 

  16. Benton-Weil W, Weil LS (1999) The Cobb procedure for stage II posterior tibial tendon dysfunction. Clin Podiatr Med Surg 16(3):471–477

    PubMed  CAS  Google Scholar 

  17. Maxwell J, Nakra A, Ashley C (2000) Use of the Maxwell–Brancheau arthroereisis implant for the correction of posterior tibial tendon dysfunction. Tech Orthop 15(3):183–196

    Article  Google Scholar 

  18. Zaret DI, Myerson MS (2003) Arthroerisis of the subtalar joint. Foot Ankle Clin N Am 8:605–617

    Article  Google Scholar 

  19. Arangio GA, Reinert KL, Salathe EP (2004) A biomechanical model of the effect of subtalar arthroereisis on the adult flexible flat foot. Clin Biomech 19(8):847–852

    Article  Google Scholar 

  20. Giannini S, Kenneth A (1998) Johnson memorial lecture: operative treatment of the flatfoot: why and how. Foot Ankle Int 19(1):52–56

    PubMed  CAS  Google Scholar 

  21. Giannini S, Ceccarelli F, Benedetti MG, Catani F, Faldini C (2001) Surgical treatment of flexible flatfoot in children. J Bone Joint Surg 83-A:73–79

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopaedics and Traumatology, North District Hospital, 9 Po Kin Road, Sheung Shui, NT, Hong Kong SAR, China

    T. H. Lui

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  1. T. H. Lui
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Correspondence to T. H. Lui.

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Lui, T.H. Endoscopic assisted posterior tibial tendon reconstruction for stage 2 posterior tibial tendon insufficiency. Knee Surg Sports Traumatol Arthr 15, 1228–1234 (2007). https://doi.org/10.1007/s00167-006-0282-8

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  • DOI: https://doi.org/10.1007/s00167-006-0282-8

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