Functional Results of Posterior Tibial Tendon Reconstruction, Calcaneal Ostetomy, and Gastrocnemius Recession

Abstract

Reconstruction of the flexible adult acquired flatfoot with FDL transfer, double calcaneal osteotomy, and gastrocnemius recession yielded excellent functional results for the treatment of Stage II posterior tibial tendon insufficiency. Plantarflexion weakness was not found to be a concern. A good functional outcome can be anticipated after the early postoperative period. However, it should be expected to take at least 1 year for maximal benefit.

Adult-Acquired Flatfoot Deformity

“…2,37 To address the problem, many surgeons use gastrocnemius recession or Achilles tendon lengthening. 74 Based on the preoperative and intraoperative Silfverskiold test, either a gastrocnemius recession (for isolated gastrocnemius tightness) or Achilles lengthening (for gastrocnemius-soleus tightness) is performed. 119 These are both adjunct procedures for AAFD and are not done in isolation.…”

Surgery for adult acquired flatfoot due to posterior tibial tendon dysfunction reduces pain, improves function and health related quality of life

“…There are few prospective studies that evaluated outcome of surgery in patients with stage II AFFD. Wacker et al [20] and van der Krans et al [21] found improvement in the partly validated American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale (A-HF) [32] from before to 2 years after surgery as did Kou et al [22] when using the Foot and Ankle Outcome Score (FAOS). Some retrospective follow-up studies without pre-operative data also found favorable functional outcome 2-5 years after surgery [16][17][18].…”

“…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). Results: The improvement from before to 24 months after surgery was in SEFAS mean 12 (95% confidence interval 8-15), SF-36 physical function 21 (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22), SF-36 bodily pain 28 , EQ-5D 0.2 (0.1-0.3) and EQ-VAS 11 (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21). Conclusion: Surgery for AFFD due to PTTD results in reduced pain and improved function and health related quality of life.…”

“…Surgery becomes an option after failed non-surgical treatment. There are less than 20 published studies that evaluate the outcome of this type of surgery, most are small retrospective investigations [11][12][13][14][15][16][17][18][19] with only postoperative data presented [23][24][25][26] and only few use a prospective design [20][21][22]. The aim of this study was to prospectively evaluate surgery for stage II AAFD.…”

Adult Acguired Flatfoot Deformity (Review)

“…Поэтому, учитывая опыт многих исследовате-лей [43], можно сделать вывод, что только ком-бинация различных хирургических действий способна привести к желаемому результату [79,59,41].…”