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Posterior tibial tendon dysfunction in the adult: current concepts
Benjamin E Stein1, Lew C Schon
1Fellow, Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, Maryland.
Instructional Course Lectures
|March 10, 2015
Summary
Posterior tibial tendon dysfunction (PTTD) management now emphasizes early diagnosis and joint-sparing surgeries like osteotomies and tendon transfers after non-surgical treatments fail. Understanding PTTD pathophysiology, diagnosis, and surgical techniques is crucial for effective adult treatment.
Area of Science:
- Orthopedics
- Foot and Ankle Surgery
- Biomedical Engineering
Background:
- Posterior tibial tendon dysfunction (PTTD) is a common cause of adult acquired flatfoot.
- Management strategies for PTTD have evolved, with ongoing debate on optimal treatment algorithms.
Purpose of the Study:
- To provide an overview of the current understanding and management of PTTD in adults.
- To highlight the shift towards early surgical intervention for PTTD.
Main Methods:
- Review of current literature on PTTD pathophysiology, diagnosis, and treatment.
- Discussion of joint-sparing surgical techniques including corrective osteotomies and tendon transfers.
Main Results:
- Nonsurgical modalities are typically exhausted before surgical intervention.
- Joint-sparing surgeries are increasingly favored for early PTTD management.
Conclusions:
- Familiarity with PTTD pathophysiology, diagnostic criteria, and surgical techniques is essential.
- A structured approach integrating early diagnosis and appropriate surgical intervention improves PTTD outcomes.
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