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Ashim Wadehra, Lawrence M Fallat, Robert Jarski
Posterior tibial tendon dysfunction (PTTD) is a common pathology of the foot and ankle. Numerous techniques are available to reconstruct the flatfoot. Fusions and tendon transfers are popular methods; however, a wide range of complications have been associated with these procedures. The objective of the present study was to demonstrate the outcomes of reconstructive surgery for flatfoot correction without tendon transfer or arthrodesis. We performed a retrospective study of 43 patients and 56 feet who had undergone flatfoot reconstructive surgery from November 2011 to June 2016, with a mean follow-up period of 60 weeks (range 12 to 60 months)...
March 30, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Alessio Bernasconi, Francesco Sadile, Matthew Welck, Nazim Mehdi, Julien Laborde, François Lintz
BACKGROUND: Stage II tibialis posterior tendon dysfunction (PTTD) resistant to conservative therapies is usually treated with invasive surgery. Posterior tibial tendoscopy is a novel technique being used in the assessment and treatment of posterior tibial pathology. The aims of this study were (1) to clarify the role of posterior tibial tendon tendoscopy in treating stage II PTTD, (2) to arthroscopically classify spring ligament lesions, and (3) to compare the arthroscopic assessment of spring ligament lesions with magnetic resonance imaging (MRI) and ultrasonographic (US) data...
April 2018: Foot & Ankle International
Megan H Ross, Michelle D Smith, Bill Vicenzino
BACKGROUND: Posterior tibial tendon dysfunction (PTTD) and adult acquired flatfoot deformity (AAFD) are used interchangeably, although both suggest quite different pathological processes. OBJECTIVE: To investigate key differences in selection criteria used for inclusion into research studies. METHODS: An electronic database search was performed from inception to June 2016. All primary research articles with clear inclusion/diagnostic criteria for PTTD or AAFD were included in the review...
2017: PloS One
Tianyong Jiang, Junbo Zheng, Linsheng Huo, Gangbing Song
With the development of the post-tensioning technique, prestressed concrete structures have been widely used in civil engineering. To ensure the long-term effectiveness of the prestressed tendon, the grouting quality of the tendon duct is one of the important factors. However, it is still a challenge to monitor the grouting quality of post-tensioning tendon ducts, due to the invisibility of the grouting. The authors' previous work proposed a real-time method that employed a stress wave-based active sensing approach with piezoceramic transducers to monitor the grouting compactness of a Post-Tensioning Tendon Duct (PTTD)...
September 29, 2017: Sensors
Duo Wai-Chi Wong, Yan Wang, Tony Lin-Wei Chen, Aaron Kam-Lun Leung, Ming Zhang
Subtalar joint arthroereisis (SJA) has been introduced to control the hyperpronation in cases of flatfoot. The objective of this study is to evaluate the biomechanical consequence of SJA to restore the internal stress and load transfer to the intact state from the attenuated biomechanical condition induced by posterior tibial tendon dysfunction (PTTD). A three-dimensional finite element model of the foot and ankle complex was constructed based on clinical images of a healthy female (age 28 years, height 165 cm, body mass 54 kg)...
November 2017: Computer Methods in Biomechanics and Biomedical Engineering
Alberto Ruffilli, Francesco Traina, Sandro Giannini, Roberto Buda, Fabrizio Perna, Cesare Faldini
INTRODUCTION: Grade II chronic tibialis posterior tendon dysfunction (PTTD) poses a reconstructive challenge to the orthopaedic surgeon. Aim of this retrospective study is to report the clinical and radiographical results of a case series of 63 patients (102 ft) affected by grade II PTTD who underwent tailored surgical treatment at 10-year mean follow-up. MATERIALS AND METHODS: Sixty-three patients (102 ft) were available for clinical and radiological evaluation and were retrospectively reviewed at a mean follow-up of 125...
January 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Tae-Ha Lim, Hyung Rae Cho, Keum Nae Kang, Chang Joon Rhyu, Sung Won Chon, Young Su Lim, Jee In Yoo, Jung-Won Kim, Young Uk Kim
RATIONALE: Ankle syndesmotic injuries occasionally require long-term therapy for recovery and can result in tendon injury. Posterior tibial tendon dysfunction (PTTD) is an acquired deformity that can cause flatfoot deformity. The current nonoperative management of PTTD includes nonsteroidal antiinflammatory drugs (NSAIDs), orthopedic devices. Although various treatment options have been attempted, optimal treatments for each stage of the condition are debated. Polydeoxyribonucleotide (PDRN) is effective in healing of chronic wounds associated with tissue damage by attracting tissue growth factors...
December 2016: Medicine (Baltimore)
Naoki Yoshioka, Kazuya Ikoma, Masamitsu Kido, Kan Imai, Masahiro Maki, Yuji Arai, Hiroyoshi Fujiwara, Daisaku Tokunaga, Nozomu Inoue, Toshikazu Kubo
BACKGROUND: The recent classifications for posterior tibial tendon dysfunction (PTTD) stage II are based on forefoot deformity, but there is still no consensus regarding a detailed explanation of the clinical condition. The purposes of this study were to clarify the clinical condition of flatfoot deformity using three-dimensional (3D) computed tomography (CT) imaging under loading on both healthy and flat feet and to compare 3D movement of the forefoot in response to load. METHODS: Ten volunteers and 10 PTTD stage II patients with symptomatic flatfoot deformity were examined...
March 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Christopher Neville, Mary Bucklin, Nathaniel Ordway, Frederick Lemley
STUDY DESIGN: Controlled laboratory, repeated measures. BACKGROUND: Posterior tibial tendon dysfunction is a common musculoskeletal problem that includes tendon degeneration and collapse of the medial arch of the foot (flatfoot deformity). Ankle-foot orthoses (AFOs) typically are used to correct flatfoot deformity. Correction of flatfoot deformity involves increasing forefoot adduction, forefoot plantar flexion, and hindfoot inversion. OBJECTIVES: To test whether a foot orthosis with a lateral extension reduces forefoot abduction in patients with stage II posterior tibial tendon dysfunction while walking...
January 2016: Journal of Orthopaedic and Sports Physical Therapy
M C Cöster, B E Rosengren, A Bremander, M K Karlsson
BACKGROUND: Patients with adult acquired flatfoot deformity (AAFD) due to posterior tibial tendon dysfunction (PTTD) may require surgery but few reports have evaluated the outcome. METHODS: We evaluated 21 patients with a median age of 60 (range 37-72) years who underwent different surgical reconstructions due to stage II AAFD before and 6 and 24 months after surgery by the validated Self-Reported Foot and Ankle Score (SEFAS), Short Form 36 (SF-36) and Euroquol 5 Dimensions (EQ-5D)...
December 2015: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Michael A Arnoldner, Michael Gruber, Stefanie Syré, Karl-Heinz Kristen, Hans-Jörg Trnka, Franz Kainberger, Gerd Bodner
PURPOSE: Posterior tibial tendon dysfunction is the most common cause of acquired asymmetric flatfoot deformity. The purpose of this study was to determine and compare the diagnostic value of MRI and high-resolution ultrasound (HR-US) in posterior tibial tendon dysfunction (PTTD), and assess their correlation with intraoperative findings. MATERIALS AND METHODS: We reviewed 23 posterior tibial tendons in 23 patients with clinical findings of PTTD (13 females, 10 males; mean age, 50 years) with 18MHz HR-US and 3T MRI...
September 2015: European Journal of Radiology
Kemal Erol, Ali Yavuz Karahan, Ülkü Kerimoğlu, Banu Ordahan, Levent Tekin, Muhammed Şahin, Ercan Kaydok
Posterior tibial tendon dysfunction (PTTD) is an important cause of acquired pes planus that frequently observed in adults. Factors that play a role in the development of PTTD such as age-related tendon degeneration, inflammatory arthritis, hypertension, diabetes mellitus, obesity, peritendinous injections and more rarely acute traumatic rupture of the tendon. PTT is the primary dynamic stabilizer of medial arch of the foot. Plantar flexion and inversion of the foot occurs with contraction of tibialis posterior tendon, and arch of the foot becomes elaveted while midtarsal joints are locked and midfoot-hindfoot sets as rigid...
January 28, 2015: Clinics and Practice
Jian Xu, Yijun Zhang, Hassan Muhammad, Xu Wang, Jiazhang Huang, Chao Zhang, Xiang Geng, Xin Ma
BACKGROUND: This study aims to evaluate the rotation and translation of each joint in the hindfoot and compare the differences in healthy foot with that in stage II PTTD flatfoot by analyzing the reconstructive three-dimensional (3D) computed tomography (CT) image data during several extreme positions. METHODS: CT scans of 20 healthy feet and 20 feet with stage II PTTD flatfoot were taken in maximal positions of plantarflexion, dorsiflexion, inversion, eversion, external rotation and internal rotation conditions...
May 2015: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Liang Gao, Justin S Yuan, Gregory J Heden, John A Szivek, Mihra S Taljanovic, L Daniel Latt, Russell S Witte
Posterior tibial tendon dysfunction (PTTD) is a common degenerative condition leading to a severe impairment of gait. There is currently no effective method to determine whether a patient with advanced PTTD would benefit from several months of bracing and physical therapy or ultimately require surgery. Tendon degeneration is closely associated with irreversible degradation of its collagen structure, leading to changes to its mechanical properties. If these properties could be monitored in vivo, they could be used to quantify the severity of tendonosis and help determine the appropriate treatment...
April 2015: IEEE Transactions on Bio-medical Engineering
M G Amila N Silva, Si Heng Sharon Tan, Hwei Chi Chong, Hsien Ching David Su, Inderjeet Rikhraj Singh
BACKGROUND: The prevalence of tibialis posterior tendon dysfunction (PTTD) is estimated to be as high as 3% to 4% in Western populations, and it is one of the most commonly misdiagnosed conditions of the foot and ankle. METHODS: Clinical and radiological outcomes were assessed in grade IIB PTTD treated with a medializing calcaneal osteotomy, lateral column lengthening, flexor digitorum longus transfer, and tendo-Achilles lengthening. The clinical and radiological findings recorded were the SF-36 score on physical function and mental health, midfoot and hindfoot American Orthopaedic Foot and Ankle Society (AOFAS) clinical scores, the midfoot and visual analog pain scores, as well as the radiological measurements of the hindfoot calcaneal pitch, talo-first metatarsal angle, and medial cuneiform height...
February 2015: Foot & Ankle International
Kyle S Peterson, Christopher F Hyer
Adult acquired flatfoot deformity is a debilitating musculoskeletal condition affecting the lower extremity. Posterior tibial tendon dysfunction (PTTD) is the primary etiology for the development of a flatfoot deformity in an adult. PTTD is classified into 4 stages (with stage IV subdivided into stage IV-A and IV-B). This classification is described in detail in this article.
July 2014: Clinics in Podiatric Medicine and Surgery
Jeremy L Walters, Samuel S Mendicino
Classically, adult posterior tibial tendon dysfunction (PTTD) was considered primarily a tendon rupture and was treated as such with soft tissue repair alone. The understanding that PTTD involves more than simply an inflammatory condition or tendon rupture but also a muscle imbalance, leading to a flatfoot, osteoarthritis, and peritalar subluxation, led to surgeons advocating osseous procedures as well. The advancements in knowledge of the pathomechanics of the deformity have modified the role that soft tissue repair plays in surgical treatment, but the importance of soft tissue restoration in flatfoot repair should not be overlooked...
July 2014: Clinics in Podiatric Medicine and Surgery
Łukasz Kołodziej, Marek Napiontek, Arkadiusz Kazimierczak
BACKGROUND: Posterior tibial tendon dysfunction (PTTD) ranks among the most common causes of adult acquired flatfoot deformity. The deformity develops gradually through characteristic stages and its early manifestations are often ignored or mis-diagnosed. The aim of the study was to gain an insight into what the participants of the 5th Polish Foot and Ankle Society Congress knew about the diagnosis and treatment of flatfoot. MATERIAL AND METHODS: An anonymous survey described the clinical presentation of a hypothetical patient with fixed stage III (according to the Johnson and Strom classification) acquired flatfoot deformity in PTTD...
November 2013: Ortopedia, Traumatologia, Rehabilitacja
Jose Antônio Veiga Sanhudo, Joao Luiz Ellera Gomes
BACKGROUND: Leg length discrepancy (LLD) is associated with a variety of orthopaedic disorders and biomechanical gait changes that involve possible overload of the posterior tibial tendon (PTT). In view of the biomechanical disturbances induced by LLD, an association may exist between LLD and PTT dysfunction (PTTD). PURPOSE: To compare the frequency and magnitude of LLD between subjects with and without PTTD and ascertain whether associations exist between clinical features and presence of dysfunction...
April 2014: Foot & Ankle Specialist
Y Zhang, J Xu, X Wang, J Huang, C Zhang, L Chen, C Wang, X Ma
OBJECTIVE: The objective of this study was to evaluate the rotation and translation of each joint in the hindfoot and compare the load response in healthy feet with that in stage II posterior tibial tendon dysfunction (PTTD) flatfoot by analysing the reconstructive three-dimensional (3D) computed tomography (CT) image data during simulated weight-bearing. METHODS: CT scans of 15 healthy feet and 15 feet with stage II PTTD flatfoot were taken first in a non-weight-bearing condition, followed by a simulated full-body weight-bearing condition...
2013: Bone & Joint Research
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