Stage I and II Posterior Tibial Tendon Dysfunction Treated by a Structured Nonoperative Management Protocol: An Orthosis and Exercise Program

@article{Alvarez2006StageIA,
  title={Stage I and II Posterior Tibial Tendon Dysfunction Treated by a Structured Nonoperative Management Protocol: An Orthosis and Exercise Program},
  author={Richard G. Alvarez and Andrew Marini and C Schmitt and Charles L Saltzman},
  journal={Foot \& Ankle International},
  year={2006},
  volume={27},
  pages={2 - 8}
}
Background: Posterior tibial tendon dysfunction (PTTD) is a relatively common problem of middle-aged adults that usually is treated operatively. The purpose of this study was to identify strength deficits with early stage PTTD and to assess the efficacy of a focused nonoperative treatment protocol. Methods: Forty-seven consecutive patients with stage I or II posterior tibial tendon dysfunction were treated by a structured nonoperative protocol. Criteria for inclusion were the presence of a… 
Results of Non-Surgical Treatment of Stage II Posterior Tibial Tendon Dysfunction: A 7- to 10-Year Followup
TLDR
Treatment of Stage II PTTD with a DUAFO has been shown to be a viable alternative to surgery with a high likelihood of adequate function, avoidance of surgery, and being brace-free at 7- to 10-year followup.
Non-surgical treatment of pain associated with posterior tibial tendon dysfunction: study protocol for a randomised clinical trial
TLDR
The analysis of changes in gait mechanics and neuromuscular control will contribute to an enhanced understanding of functional changes and eventually optimise conservative management strategies for patients with posterior tibial tendon dysfunction and accompanying pes planovalgus.
Choosing among 3 ankle-foot orthoses for a patient with stage II posterior tibial tendon dysfunction.
TLDR
A quantitative gait analysis was used and a higher-cost custom articulated orthosis was chosen as optimal for the patient, feeling it produced the greatest correction in foot deformity.
The Effect of Stage II Posterior Tibial Tendon Dysfunction on Deep Compartment Muscle Strength: A New Strength Test
TLDR
A subtalar inversion and forefoot adduction strength deficit by 20% to 30% in subjects with Stage II PTTD is confirmed, demonstrating the weakness in this population.
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TLDR
Foot orthoses with personalised internal longitudinal arch support were more effective than flat insoles or standard treatments in reducing pain and the use of orthotic treatment may be effective in reducingPain in the early stages of posterior tibial tendon dysfunction.
An Ankle-Foot Orthosis With a Lateral Extension Reduces Forefoot Abduction in Subjects With Stage II Posterior Tibial Tendon Dysfunction.
TLDR
Off-the-shelf and standard AFOs have been shown to improve forefoot plantar flexion and hindfoot eversion, but not forefoot adduction, but a lateral extension added to a standard A FO along the forefoot significantly improved fore foot adduction in participants with posterior tibial tendon dysfunction while walking.
Effects of a 4-Week Short-Foot Exercise Program on Gait Characteristics in Patients With Stage II Posterior Tibial Tendon Dysfunction.
TLDR
The authors' 4-week SFE program may have positive effects on changing muscle activation patterns for tibialis anterior and fibularis longus muscles, although it could not influence their structural deformity and ankle joint moment.
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TLDR
A novice triathlete with a grade I tibialis posterior strain was quickly relieved of his symptoms and able to return to his triathlon training with conservative treatment.
PTT Functional Recovery in Early Stage II PTTD After Tendon Balancing and Calcaneal Lengthening Osteotomy
TLDR
This study challenges the understanding of early Stage II PTTD as well as the surgical guidelines recommending PTT augmentation at this specific stage, by providing evidence of PTT functional recovery without augmentation in early Stage I.
Results of Operative Correction of Grade IIB Tibialis Posterior Tendon Dysfunction
TLDR
Grade IIB PTTD treated with a medializing calcaneal osteotomy, lateral column lengthening, flexor digitorum longus transfer, and tendo-Achilles lengthening demonstrated statistical significant improvement in hindfoot and midfoot AOFAS scores, SF-36 physical function scores, as well as visual analog scores.
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References

SHOWING 1-10 OF 70 REFERENCES
Instructional Course Lectures, The American Academy of Orthopaedic Surgeons - Adult Acquired Flatfoot Deformity. Treatment of Dysfunction of the Posterior Tibial Tendon*†
  • M. Myerson
  • Medicine
    Instructional course lectures
  • 1997
TLDR
Treatment for acquired flatfoot deformity caused by dysfunction of the posterior tibial tendon includes non-operative options, such as rest, administration of anti-inflammatory medication, and immobilization, as well as operative options,such as tendon transfer, calcaneal osteotomy, and several methods of arthrodesis.
Nonoperative Management of Posterior Tibial Tendon Dysfunction
TLDR
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.
Acquired flatfoot in adults due to dysfunction of the posterior tibial tendon.
TLDR
The current thinking with regard to the pathophysiology, clinical evaluation, and decision-making process for the treatment of dysfunction of the posterior tibial tendon is reviewed.
Tibialis posterior tendon dysfunction.
TLDR
The importance of the tibialis posterior tendon in normal hindfoot function and its treatment when injured are now being properly appreciated.
MR imaging of posterior tibial tendon dysfunction.
TLDR
MR imaging is effective for detecting abnormalities related to posterior tibial tendon dysfunction and Familiarity with the appearance of these changes facilitates accurate characterization.
Spontaneous Rupture of the Tibialis Posterior Tendon: Clinical Findings, Tenographic Studies, and a New Technique of Repair
TLDR
It was concluded that while tenography was a significant diagnostic adjuvant, the diagnosis and decision for surgical intervention must be based primarily upon the clinical findings.
Tendon Disorders of the Foot and Ankle
  • Donald C. Jones
  • Medicine
    The Journal of the American Academy of Orthopaedic Surgeons
  • 1993
TLDR
The painful os peroneum syndrome is a newly described spectrum of posttraumatic conditions that may be the cause of lateral foot pain, which is frequently difficult to identify.
Tibialis posterior tendon rupture.
  • K. A. Johnson
  • Medicine
    Clinical orthopaedics and related research
  • 1983
TLDR
Watch for such deformities as too many toes and including the single heel rise test in the examination will facilitate an accurate diagnosis ofupture of the tibialis posterior tendon.
...
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