Posterior Tibial Tendon Insufficiency Results at Different Stages

HSS Journal


Martin J. O'Malley, MD

Martin J. O'Malley, MD

Associate Attending Orthopaedic Surgeon, Hospital for Special Surgery
Assistant Professor of Orthopedic Surgery, Weill Cornell Medical College

Jonathan T. Deland, MD

Jonathan T. Deland, MD

Co-Chief of the Foot and Ankle Service, Hospital for Special Surgery
Attending Orthopaedic Surgeon, Hospital for Special Surgery

Alexandra Page, MD
Department of Orthopaedic Surgery
Hospital for Special Surgery

Il-Hoon Sung, MD
Department of Orthopaedic Surgery
Hospital for Special Surgery

David Inda, MD
Department of Orthopaedic Surgery
Hospital for Special Surgery

Steven Choung, MD
Department of Orthopaedic Surgery
Hospital for Special Surgery

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.

This article appears in HSS Journal: Volume 2, Number 2.
View the full article at springerlink.com.


About the HSS Journal
HSS Journal, an academic peer-reviewed journal, is published twice a year, February and September, and features articles by internal faculty and HSS alumni that present current research and clinical work in the field of musculoskeletal medicine performed at HSS, including research articles, surgical procedures, and case reports.

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