488 results match your criteria Acquired Flatfoot


Evaluation and Treatment of Posterior Tibialis Tendon Insufficiency in the Elderly Patients.

Geriatr Orthop Surg Rehabil 2019 24;10:2151459318821461. Epub 2019 Jan 24.

Department of Orthopaedics and Rehabilitation, University of Rochester Medical Center, Rochester, NY, USA.

Introduction: Posterior tibialis tendon insufficiency is the most common cause of adult acquired flatfoot deformity in elderly patients. We performed a literature search of primary and secondary journal articles pertaining to posterior tibialis tendon insufficiency in the geriatric population. We examined relevant data from these articles regarding current evaluation in addition to both conservative and advanced treatment approaches that correspond to disease severity. Read More

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http://dx.doi.org/10.1177/2151459318821461DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6348568PMC
January 2019
1 Read

Anatomic study of the medial side of the ankle base on the joint capsule: an alternative description of the deltoid and spring ligament.

J Exp Orthop 2019 Jan 28;6(1). Epub 2019 Jan 28.

Department of Clinical Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.

Background: Adult acquired flatfoot deformity (AAFD) is caused by impaired medial ligamentous structures and posterior tibialis tendon dysfunction (PTTD). Although degeneration and trauma could separately cause AAFD, how these factors interact in the pathomechanism of AAFD is unclear. The joint capsule in the medial ankle is considered an important structure, providing passive stability by limiting joint movement. Read More

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http://dx.doi.org/10.1186/s40634-019-0171-yDOI Listing
January 2019
1 Read

Analysis of the main passive soft tissues associated with adult acquired flatfoot deformity development: A computational modeling approach.

J Biomech 2019 Feb 9;84:183-190. Epub 2019 Jan 9.

Applied Mechanics and Bioengineering Group (AMB), Aragón Institute of Engineering Research (I3A), Universidad de Zaragoza, Spain.

Adult acquired flatfoot deformity (AAFD) is a pathology with a wide range of treatment options. Physicians decide the best treatment based on their experience, so the process is entirely subjective. A better understanding of soft tissue stress and its contribution in supporting the plantar arch could help to guide the clinical decision. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00219290193001
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http://dx.doi.org/10.1016/j.jbiomech.2018.12.047DOI Listing
February 2019
2 Reads

Postoperative Medial Cuneiform Position Correlation With Patient-Reported Outcomes Following Cotton Osteotomy for Reconstruction of the Stage II Adult-Acquired Flatfoot Deformity.

Foot Ankle Int 2019 Jan 18:1071100718822839. Epub 2019 Jan 18.

1 Hospital for Special Surgery, New York, NY, USA.

Background:: Residual supination of the midfoot during reconstruction of the stage II adult-acquired flatfoot deformity (AAFD) is often addressed with a medial cuneiform (Cotton) osteotomy after adequate correction of the hindfoot valgus deformity. The purpose of this study was to determine if there was a correlation between postoperative alignment of the medial cuneiform and patient-reported outcomes.

Methods:: Sixty-three feet in 61 patients with stage II AAFD who underwent a Cotton osteotomy as part of a flatfoot reconstruction were included the study. Read More

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http://dx.doi.org/10.1177/1071100718822839DOI Listing
January 2019

Naviculocuneiform Arthrodesis in Adult Flatfoot: A Case Series.

J Foot Ankle Surg 2019 Jan 3. Epub 2019 Jan 3.

Attending Physician, Virginia Mason Medical Center, Seattle, WA.

Medial column arthrodesis and calcaneal osteotomies are commonly used for adult-acquired flatfoot surgical reconstruction. In this case series, 10 patients (11 feet) with a mean age of 54 ± 13 years underwent a medial column arthrodesis, with or without calcaneal osteotomy, between 2010 and 2017. The indication for surgery was a painful flatfoot deformity with peritalar subluxation and a fault in the naviculocuneiform joint. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S10672516183036
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http://dx.doi.org/10.1053/j.jfas.2018.08.027DOI Listing
January 2019
3 Reads

Occurrence of Lateral Ankle Ligament Disease With Stage 2 to 3 Adult-Acquired Flatfoot Deformity Confirmed via Magnetic Resonance Imaging: A Retrospective Study.

J Foot Ankle Surg 2018 Dec 21. Epub 2018 Dec 21.

Director of Residency Training, Division of Foot & Ankle Surgery, West Penn Hospital, Allegheny Health Network, Pittsburgh, PA. Electronic address:

Lateral hindfoot pain associated with stage 2 to 3 adult-acquired flatfoot is often attributed to subfibular impingement. Preoperative magnetic resonance imaging (MRI) is generally performed to assess the extent of degeneration within the posterior tibial tendon, attenuation of medial soft tissue constraints, and degeneration of hindfoot and/or ankle articulations. The purpose of this study is to determine the incidence of lateral collateral ligament disease/injury associated with stages 2 and 3 adult-acquired flatfoot. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S10672516183037
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http://dx.doi.org/10.1053/j.jfas.2018.08.030DOI Listing
December 2018
2 Reads

Repair of the Deltoid Ligament Using Posterior Tibial Tendon Autograft:A Novel Technique.

J Foot Ankle Surg 2019 Jan;58(1):165-170

Faculty, Division of Foot & Ankle Surgery, West Penn Hospital, Allegheny Health Network, Pittsburgh, PA. Electronic address:

Posterior tibial tendon dysfunction (PTTD) is a progressive disorder secondary to advanced degeneration of the posterior tibial tendon, leading to the abduction of the forefoot, valgus rotation of the hindfoot, and collapse of the medial longitudinal arch. Eventually, the disease becomes so advanced that it begins to affect the deltoid ligament over time. This attenuation and eventual tear of the deltoid ligament leads to valgus deformity of the ankle. Read More

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http://dx.doi.org/10.1053/j.jfas.2018.07.002DOI Listing
January 2019

Three-dimensional displacement after a medializing calcaneal osteotomy in relation to the osteotomy angle and hindfoot alignment.

Foot Ankle Surg 2018 Dec 7. Epub 2018 Dec 7.

Department of Orthopaedic Surgery, Ghent University Hospital, De Pintelaan 185, 9000 Gent, Belgium; University Orthopaedic Center, University of Utah, 590 Wakara Way Salt Lake City, UT 84108, USA.

Background: A medializing calcaneal osteotomy is frequently performed to correct adult-acquired flatfoot deformities, but there is lack of data on the associated three-dimensional variables defining the final correction. The aim of this study was to assess the correlation between the pre-operative hindfoot valgus deformity and calcaneal osteotomy angles and the post-operative calcaneal displacement.

Methods: Weight-bearing CT scans obtained pre- and post-operatively were retrospectively analyzed for sixteen patients. Read More

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http://dx.doi.org/10.1016/j.fas.2018.11.015DOI Listing
December 2018

Biomechanical stress analysis of the main soft tissues associated with the development of adult acquired flatfoot deformity.

Clin Biomech (Bristol, Avon) 2018 Dec 17;61:163-171. Epub 2018 Dec 17.

Applied Mechanics and Bioengineering Group (AMB), Aragón Institute of Engineering Research (I3A), Universidad de Zaragoza, Spain.

Background: Adult acquired flatfoot deformity (AAFD) is traditionally related to a tibialis posterior tendon deficiency. In the intermediate stages, treatments are commonly focused on reinforcing this tissue, but sometimes the deformation appears again over time, necessitating the use of more aggressive options. Tissue stress cannot be consistently evaluated through traditional experimental trials. Read More

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http://dx.doi.org/10.1016/j.clinbiomech.2018.12.009DOI Listing
December 2018
1 Read

Spring ligament tear decreases static stability of the ankle joint.

Clin Biomech (Bristol, Avon) 2018 Nov 27;61:79-83. Epub 2018 Nov 27.

Department of Orthopaedic Surgery, University of Rochester, Rochester, NY, USA. Electronic address:

Background: Spring ligament tear is often found in advanced adult acquired flatfoot deformity and its reconstruction in conjunction with the deltoid ligament has been proposed to restore the tibiotalar and talonavicular joint stability. The aim of the present study is to determine the effect of spring ligament injury and subsequent reconstruction on static joint reactive force using a non-invasive method of measurement.

Methods: Ten fresh-frozen human cadaveric lower legs were disarticulated at the knee joint. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S02680033183097
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http://dx.doi.org/10.1016/j.clinbiomech.2018.11.011DOI Listing
November 2018
16 Reads

Remodeling of the Calcaneocuboid Joint in the Acquired Flatfoot.

Authors:
Arthur Manoli

J Surg Orthop Adv Fall 2018;27(3):237-245

Michigan International Foot and Ankle Center, St. Joseph Mercy Hospital - Oakland, Pontiac, Michigan; Departments of Orthopaedic Surgery, Wayne State University, Detroit, Michigan, and Michigan State University College of Osteopathic Medicine, East Lansing, Michigan; e-mail:

There has been debate recently as to whether the lateral column is actually short in the acquired flatfoot. Doubters argue that it is not possible for the lateral column to change in length and actually shorten, especially in the acquired type. In this series of 21 consecutive patients operated on for an acquired flatfoot, the calcaneocuboid joint (CC) had remodeled in all, resulting in the calcaneal side being short, facing laterally and dorsally. Read More

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November 2018
1 Read

Hindfoot alignment of adult acquired flatfoot deformity: A comparison of clinical assessment and weightbearing cone beam CT examinations.

Foot Ankle Surg 2018 Nov 5. Epub 2018 Nov 5.

Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 North Caroline Street, Baltimore, MD 21287, United States.

Background: Clinical assessment of hindfoot alignment (HA) in adult acquired flatfoot deformity (AAFD) can be challenging and weightbearing (WB) cone beam CT (CBCT) may potentially better demonstrate this three-dimensional (3D) deformity. Therefore, we compared clinical and WB CBCT assessment of HA in patients with AAFD.

Methods: In this prospective study, we included 12 men and 8 women (mean age: 52. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S12687731183030
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http://dx.doi.org/10.1016/j.fas.2018.10.008DOI Listing
November 2018
12 Reads

Spring Ligament Instability.

Foot Ankle Clin 2018 Dec 22;23(4):659-678. Epub 2018 Sep 22.

Department of Orthopedic Surgery, Universidad de Chile, 1027 Independencia, Santiago 8380453, Chile; Department of Orthopedic Surgery, Hospital Clinico Universidad de Chile, Santos Dumont 999, Independencia, Santiago 8380456, Chile; Clinica Universidad de los Andes, Plaza 2501, Santiago 7620157, Chile.

The crucial role of the spring ligament complex within the pathologic process that leads to flatfoot deformity has evolved recently. There has been improvement in the anatomic knowledge of the spring ligament and understanding of its complex relationship to the deltoid complex and outstanding advances in biomechanics concepts related to the spring ligament. Optimization of flatfoot treatment strategies are focused on a renewed interest in the spring ligament and medial soft tissue reconstruction in concert with bony correction to obtain an adequate reduction of the talonavicular deformity and restoration of the medial longitudinal arch. Read More

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http://dx.doi.org/10.1016/j.fcl.2018.07.012DOI Listing
December 2018

Influence of investigator experience on reliability of adult acquired flatfoot deformity measurements using weightbearing computed tomography.

Foot Ankle Surg 2018 Mar 12. Epub 2018 Mar 12.

Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Background: Our purpose was to assess the reliability of measurements of adult-acquired flatfoot deformity (AAFD) taken by investigators of different levels of clinical experience using weightbearing computed tomography (WBCT).

Methods: Nineteen AAFD patients underwent WBCT. Three investigators with different levels of clinical experience made AAFD measurements in axial, coronal, and sagittal planes. Read More

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http://dx.doi.org/10.1016/j.fas.2018.03.001DOI Listing
March 2018
2 Reads

Dynamic correction for forefoot varus in stage II-A adult flatfoot: Technique tip.

Foot Ankle Surg 2018 Jun 3. Epub 2018 Jun 3.

Head Foot & Ankle Department, Hospital Moinhos de Vento (HMV), Av. Praia de Belas 2124/701, Porto Alegre, RS, Brazil. Electronic address:

Posterior tibial tendon dysfunction (PTTD) is a progressive disorder and a common cause of adult acquired flatfoot deformity, and forefoot varus is a frequent component in advanced cases. The author proposes peroneus brevis-to-longus transfer as an additional step to correct the forefoot varus component of stage II-A posterior tibial tendon dysfunction. We have performed this dynamic correction of forefoot varus in 12 patients at our institution, and observed promising clinical and radiographic improvement. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S12687731183022
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http://dx.doi.org/10.1016/j.fas.2018.05.007DOI Listing
June 2018
1 Read

Combined Subtalar and Naviculocuneiform Fusion for Treating Adult Acquired Flatfoot Deformity With Medial Arch Collapse at the Level of the Naviculocuneiform Joint.

Foot Ankle Int 2018 Oct 13:1071100718800295. Epub 2018 Oct 13.

1 Kantonsspital Baselland, Liestal, Switzerland.

Background: A challenge in treating acquired flatfoot deformities is the collapse of the medial arch at the level of the naviculocuneiform (NC) joint. Triple fusions, being a treatment option, may lead to problems such as increased foot stiffness. We thus established a method that combines subtalar (ST) fusion with NC fusion while preserving the Chopart joint. Read More

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http://journals.sagepub.com/doi/10.1177/1071100718800295
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http://dx.doi.org/10.1177/1071100718800295DOI Listing
October 2018
19 Reads

Bilateral Stress Fractures of the Talus Associated with Adult-Acquired Flatfoot Deformities.

Case Rep Orthop 2018 9;2018:5376384. Epub 2018 Sep 9.

Department of Rheumatology, JCHO Yugawara Hospital, 438 Miyakami, Yugawara, Ashigarashimo, Kanagawa 259-0396, Japan.

Adult-acquired flatfoot deformity is a progressive flattening of the arch of the foot that results from posterior tibial tendon insufficiency with a predilection for middle-aged women. A lateralized force vector associated with hindfoot valgus in adult-acquired flatfoot produces lateral ankle pain due to impingement at the lateral hindfoot, which can even lead to stress fractures of the distal fibula. Here, we present the rare case of a 73-year-old woman who presented with stress fractures of the bilateral taluses and unilateral distal fibula accompanied by severe adult-acquired flatfoot deformities. Read More

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https://www.hindawi.com/journals/crior/2018/5376384/
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http://dx.doi.org/10.1155/2018/5376384DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6151209PMC
September 2018
11 Reads

[Biomechanical analysis through numerical simulation of rupture of the tibial posterior tendon in valgus flat foot: a cadeveric study].

Acta Ortop Mex 2018 Mar-Apr;32(2):82-87

Ortopedia y Traumatología del Hospital General León. León, Gto., México.

The insufficiency of the posterior tibial tendon is the most common acquired cause of pain related to valgus flatfoot deformity in adults. The acquired flatfoot adult is a very painful symptomatic deformity resulting from a gradual stretching (attenuation) of the posterior tibial tendon and ligaments that support the arch of the foot. The progressive pain acquired flatfoot adult affects four times more women than men. Read More

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September 2018
1 Read

Three-Dimensional Morphometric Modeling Measurements of the Calcaneus in Adults with Stage IIB Posterior Tibial Tendon Dysfunction: A Pilot Study.

Foot Ankle Spec 2018 Aug 31:1938640018796618. Epub 2018 Aug 31.

Department of Orthopaedic Surgery, Penn State Hershey Bone and Joint Institute (KCW, EPR, CMS, KLS, JLK, GSL, MCA) Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania.

Background: The pathophysiology of adult-acquired flatfoot deformity (AAFD) is not fully explained by degeneration of the posterior tibial tendon alone. While a shortened or dysplastic lateral column has been implicated in flatfoot deformity in pediatrics, there is no study that has quantified the degree of dysplasia in adults with a stage IIb flatfoot deformity, or if any exists at all.

Methods: An institutional radiology database was queried for patients with posterior tibial tendon dysfunction (PTTD) who had computed tomography (CT) performed. Read More

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http://dx.doi.org/10.1177/1938640018796618DOI Listing
August 2018
1 Read

Subtalar Joint Biomechanics: From Normal to Pathologic.

Foot Ankle Clin 2018 Sep 3;23(3):341-352. Epub 2018 Jul 3.

Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, WA, USA.

Subtalar joint biomechanics are primarily driven by the shape of the articulations with contributions from the surrounding soft tissues. The joint motion occurs about a single axis oriented medially and superiorly. Joint contact forces change during different stages of gait and are affected by hindfoot alignment and traumatic alterations to their normal anatomy. Read More

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http://dx.doi.org/10.1016/j.fcl.2018.04.002DOI Listing
September 2018
2 Reads

Effect of the calcaneal medializing osteotomy on soft tissues supporting the plantar arch: A computational study.

Rev Esp Cir Ortop Traumatol 2018 Jun 12. Epub 2018 Jun 12.

Grupo de Mecánica aplicada y Bioingeniería (AMB), Instituto de Investigación en Ingeniería de Aragón (I3A), Universidad de Zaragoza, Zaragoza, España.

Medializing calcaneal osteotomy forms part of the treatment options for adult acquired flat foot. The structural correction that is achieved is widely known. However, the effect of this procedure on the soft tissues that support the plantar arch has been little studied, since it is not possible to quantify experimentally the tension and deformation variations generated. Read More

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http://dx.doi.org/10.1016/j.recot.2018.04.003DOI Listing
June 2018
3 Reads

Acquired Flat-foot in a Child (Report of a Case).

J Orthop Case Rep 2018 Jan-Feb;8(1):64-66

Department of Orthopaedic, Ordibehesht Hospital, Shiraz, Iran.

Introduction: Unilateral secondary flat-foot in children is unusual, and in the absence of a major trauma history should raise suspicion of a neuromuscular etiology. Flatfoot from tibialis posterior tendon (TPT) rupture in children is very rare.

Case Report: A 10-year-old girl presented with unilateral flatfoot and unusual shoe wear of few years duration. Read More

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http://dx.doi.org/10.13107/jocr.2250-0685.1002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5974681PMC
June 2018
12 Reads

Passive engineering mechanism enhancement of a flexor digitorum longus tendon transfer procedure.

J Orthop Res 2018 Nov 13;36(11):3033-3042. Epub 2018 Jun 13.

RR&D Center for Limb Loss and MoBility, VA Puget Sound Health Care System, Seattle, Washington.

Standard treatments of adult acquired flatfoot deformity (AAFD) fail to correct associated dysfunction of the posterior tibial tendon (PTT). This study aimed to determine if a novel passive engineering mechanism (PEM) enhanced flexor digitorum longus (FDL) tendon transfer procedure would better restore physiologic PTT function to improve AAFD gait parameters compared to standard treatment. We evaluated the kinetic, pedobarographic, and kinematic effects of a pulley-based PEM-enhancement system utilizing a cadaveric flatfoot model and robotic gait simulator. Read More

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http://dx.doi.org/10.1002/jor.24051DOI Listing
November 2018
1 Read

Outcomes of Reconstruction of the Stage II Adult-Acquired Flatfoot Deformity in Older Patients.

Foot Ankle Int 2018 Sep 18;39(9):1019-1027. Epub 2018 May 18.

1 Hospital for Special Surgery, New York, NY, USA.

Background: Reconstruction of the stage II adult-acquired flatfoot deformity (AAFD) often requires the use of multiple osteotomies and soft tissue procedures that may not heal well in older patients. The purpose of our study was to determine whether patients older than 65 years with stage II AAFD had inferior clinical outcomes or an increased number of subsequent surgical procedures after flatfoot reconstruction when compared with younger patients.

Methods: One-hundred forty consecutive feet (70 right, 70 left) with stage II AAFD in 137 patients were divided into 3 groups based on age: younger than 45 years (young; n = 21), 45 to 65 years (middle-aged; n = 87), and 65 years and older (older; n = 32). Read More

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http://journals.sagepub.com/doi/10.1177/1071100718777459
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http://dx.doi.org/10.1177/1071100718777459DOI Listing
September 2018
3 Reads

Hallux Valgus/Medial Column Instability and Their Relationship with Posterior Tibial Tendon Dysfunction.

Foot Ankle Clin 2018 Jun;23(2):297-313

Spectrum Health - Michigan State University, 221 Michigan Street NE, Suite 402, Grand Rapids, MI 49503, USA.

Historically, bunions have focused on the coronal plane; however, there is tension and compression failure in the sagittal plane of the midfoot during arch collapse. Correction of all 3 planes of deformity, coronal, sagittal, and rotational, can be achieved in several ways. Taking a big picture of global foot mechanics by recognizing the common types of conditions associated with arch collapse, including hallux valgus deformities, can serve as a useful roadmap for navigating more complicated deformities where hallux valgus exists. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S10837515183001
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http://dx.doi.org/10.1016/j.fcl.2018.02.003DOI Listing
June 2018
5 Reads

Combined Spring and Deltoid Ligament Repair in Adult-Acquired Flatfoot.

Foot Ankle Int 2018 08 16;39(8):903-907. Epub 2018 Apr 16.

2 Federal University of Minas Gerais, Minas Gerais, Brazil.

Background: Adult-acquired flatfoot deformity (AAFD) is usually due to a combination of mechanical failure of the osteoligamentous complex that maintains the medial longitudinal arch of the foot and attenuation or complete tear of the posterior tibial tendon. Magnetic resonance imaging studies in patients with flatfoot deformities have reported the posterior tibial tendon to be pathologic in up to 100% of patients, the spring ligament in up to 87%, and the deltoid ligament in 33%. Many studies in the literature describe reconstruction of the spring ligament or the deltoid ligament associated with AAFD, but there is no study in which both (spring and deltoid) ligaments are reconstructed at the same time. Read More

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http://journals.sagepub.com/doi/10.1177/1071100718770132
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http://dx.doi.org/10.1177/1071100718770132DOI Listing
August 2018
25 Reads

Short- to Mid-Term Outcomes Following the Use of an Arthroereisis Implant as an Adjunct for Correction of Flexible, Acquired Flatfoot Deformity in Adults.

Foot Ankle Spec 2018 Apr 1:1938640018770242. Epub 2018 Apr 1.

Department of Orthopaedic Surgery, Penn State Hershey Bone and Joint Institute, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania.

Background: The use of an arthroereisis implant for the treatment of adolescent flatfoot deformity has been described. However, data that address the outcomes of patients treated with an arthroereisis implant in adults are limited. The purpose of this study was to investigate the radiographic and clinical outcomes and complications following the use of a subtalar arthroereisis implant as an adjunct for correction acquired flatfoot deformity secondary to posterior tibial tendon dysfunction. Read More

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http://dx.doi.org/10.1177/1938640018770242DOI Listing
April 2018
2 Reads

Contribution of Medial Cuneiform Osteotomy to Correction of Longitudinal Arch Collapse in Stage IIb Adult-Acquired Flatfoot Deformity.

Foot Ankle Int 2018 08 5;39(8):885-893. Epub 2018 Apr 5.

4 Department of Foot and Ankle Surgery, Hospital for Special Surgery, New York, NY, USA.

Background Residual forefoot supination after correcting the hindfoot in stage IIb adult-acquired flatfoot deformity can be addressed with a dorsal opening wedge medial cuneiform (Cotton) osteotomy. The amount of correction is generally judged clinically, and there currently are no preoperative guides that can predict the size of graft needed. The aim of this study was to evaluate the correlation between patient and operative factors and the correction achieved with the Cotton osteotomy. Read More

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http://journals.sagepub.com/doi/10.1177/1071100718768020
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http://dx.doi.org/10.1177/1071100718768020DOI Listing
August 2018
15 Reads

Surgical Management of Stage 2 Adult and Pediatric Acquired Flatfoot Without Tendon Transfer or Arthrodesis: A Retrospective Study.

J Foot Ankle Surg 2018 Jul - Aug;57(4):658-663. Epub 2018 Mar 30.

Professor Emeritus, Oakland University School of Health Sciences, Rochester, MI.

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. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S10672516173068
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http://dx.doi.org/10.1053/j.jfas.2017.11.036DOI Listing
December 2018
8 Reads

Imaging of the Tibionavicular Ligament, and Its Potential Role in Adult Acquired Flatfoot Deformity.

Foot Ankle Int 2018 05 28;39(5):629-635. Epub 2018 Mar 28.

1 Department of Trauma and Orthopaedics, Wirral University Teaching Hospitals NHS Foundation Trust, Upton, Wirral, United Kingdom.

Background: The spring ligament is an important medial arch stabilizer. However, when disrupted, it does not cause planovalgus deformity until the foot is cyclically loaded. We propose that the tibionavicular (TN) ligament plays an important role. Read More

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http://journals.sagepub.com/doi/10.1177/1071100718764680
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http://dx.doi.org/10.1177/1071100718764680DOI Listing
May 2018
11 Reads

Correlation of Clinical Evaluation and Radiographic Hindfoot Alignment in Stage II Adult-Acquired Flatfoot Deformity.

Foot Ankle Int 2018 07 28;39(7):771-779. Epub 2018 Mar 28.

1 Hospital for Special Surgery, New York, NY, USA.

Background: Previous work has demonstrated that the amount of radiographic hindfoot correction required at the time of adult-acquired flatfoot deformity (AAFD) operative treatment can be predicted by the amount of radiographic deformity present before surgery. Successful outcomes after reconstruction are closely correlated with hindfoot valgus correction. However, it is not clear if differences exist between clinical and radiographic assessment of hindfoot valgus. Read More

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http://dx.doi.org/10.1177/1071100718762113DOI Listing
July 2018
4 Reads

Matrix metalloproteinase-1 (MMP-1) and (MMP-8) gene polymorphisms promote increase and remodeling of the collagen III and V in posterior tibial tendinopathy.

Histol Histopathol 2018 Sep 13;33(9):929-936. Epub 2018 Mar 13.

Department of Pathology, University of São Paulo, São Paulo, Brazil.

Posterior tibial tendinopathy (PTT) can lead to acquired flatfoot in adults. Many patients develop PTT without any identifiable risk factors. Molecular changes in extracellular matrix (ECM) and matrix metalloproteinase (MMP) polymorphism may influence the risk of developing PTT. Read More

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http://dx.doi.org/10.14670/HH-11-982DOI Listing
September 2018
9 Reads

Long-term follow-up of patients undergoing tibialis posterior transfer: Is acquired pes planus a complication?

Foot (Edinb) 2018 Mar 22;34:83-89. Epub 2017 Nov 22.

Queen Elizabeth Hospital, King's Lynn, United Kingdom.

In this retrospective study, a series of 10 elective patients treated with transfer of the tibialis posterior (TP) tendon for pes cavus and drop foot are described. Since TP transfer completely subtracts the role of this tendon, this cohort of patients provides an opportunity to examine the consequences of tibialis posterior (TP) deficiency. After a mean follow up period of 44. Read More

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http://dx.doi.org/10.1016/j.foot.2017.11.008DOI Listing
March 2018
9 Reads

Role of Tendoscopy in Treating Stage II Posterior Tibial Tendon Dysfunction.

Foot Ankle Int 2018 04 16;39(4):433-442. Epub 2018 Feb 16.

3 Clinique de l'Union, Ankle and Foot Surgery Center, Saint-Jean, France.

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. Read More

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http://dx.doi.org/10.1177/1071100717746192DOI Listing
April 2018
2 Reads

Posterior Tibial Tendon Endoscopic Debridement for Stage I and II Posterior Tibial Tendon Dysfunction.

Arthrosc Tech 2017 Oct 30;6(5):e2019-e2022. Epub 2017 Oct 30.

Evans Army Community Hospital, Fort Carson, Colorado, U.S.A.

Adult acquired flatfoot deformity (AAFD), formerly known as posterior tibial tendon (PTT) dysfunction, is one of the most common problems of the foot and ankle. It was first described as tendon failure but has since been revealed as ligamentous failure in addition. AAFD is a spectrum of deformities that ranges from tenosynovitis (stage I) to AAFD (stages II-IV). Read More

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https://linkinghub.elsevier.com/retrieve/pii/S22126287173025
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http://dx.doi.org/10.1016/j.eats.2017.07.023DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5797905PMC
October 2017
3 Reads

The arthroereisis procedure in adult flexible flatfoot grade IIA due to insufficiency of posterior tibial tendon.

Foot Ankle Surg 2018 04 14;24(2):171. Epub 2017 Oct 14.

Department of Sports Medicine, Shenzhen Second People's Hospital (First Affiliated Hospital of Shenzhen University), Shenzhen University, Shenzhen, 510378 Guangdong, China.

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http://dx.doi.org/10.1016/j.fas.2017.10.001DOI Listing
April 2018
4 Reads

Response to the Letter to the Editor on "The arthroereisis procedure in adult flexible flatfoot grade IIA due to insufficiency of posterior tibial tendon".

Foot Ankle Surg 2018 04 13;24(2):172. Epub 2017 Oct 13.

SM Misericordia Hospital, Orthopaedic and Traumatology Clinic, Perugia, Italy.

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http://dx.doi.org/10.1016/j.fas.2017.10.003DOI Listing
April 2018
8 Reads

Evaluation of peritalar subluxation in adult acquired flatfoot deformity using computed tomography and weightbearing multiplanar imaging.

Foot Ankle Surg 2018 Dec 12;24(6):495-500. Epub 2017 Jun 12.

Department of Foot and Ankle Surgery, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021 USA. Electronic address:

Background: The aim of this study was to assess the inferior talus-superior talus (inf-tal-sup-tal) angle (previously proven reliable in multiplanar-weight bearing imaging (MP-WB)) on both computed tomography (CT) and MP-WB scans. We sought to compare the angle between the two modalities in both AAFD and control groups, as well as to compare the groups to each other.

Methods: Inf-tal-sup-tal angles were compared between a stage II AAFD group (n=38) with routine MP-WB and CT scans and a control group (n=20) with preoperative CT scans for lisfranc injuries and normal hindfoot alignment after healing. Read More

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https://www.sciencedirect.com/science/article/pii/S126877311
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https://www.researchgate.net/publication/10611931_Deformity_
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https://linkinghub.elsevier.com/retrieve/pii/S12687731173012
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http://dx.doi.org/10.1016/j.fas.2017.05.010DOI Listing
December 2018
10 Reads

Foot and Ankle Conditions: Pes Planus.

FP Essent 2018 02;465:18-23

University of Florida College of Medicine, PO Box 100237, Gainesville, FL 32610-0237.

Pes planus or pes planovalgus (ie, flatfoot) is a common condition among young children and also is encountered in adults. In children, congenital pes planus typically resolves with age as the foot musculature strengthens. Flexible pes planus is defined as a normal arch during non-weight-bearing activity or tiptoeing, with a flattening arch on standing. Read More

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February 2018
12 Reads

Posterior tibial tendon dysfunction: Clinical and magnetic resonance imaging findings having histology as reference standard.

Eur J Radiol 2018 Feb 11;99:55-61. Epub 2017 Dec 11.

Department of Biomedical Sciences for Health, University of Milano, Via Pascal 36, 20135, Milano, Italy; Unit of Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Galeazzi, Via R. Galeazzi 4, 20166, Milano, Italy. Electronic address:

Objective: To investigate the correlation between MRI, clinical tests, histopathologic features of posterior tibial tendon (PTT) dysfunction in patients with acquired adult flatfoot deformity surgically treated with medializing calcaneal osteotomy and flexor digitorum longus tendon transposition.

Materials And Methods: Nineteen patients (11 females; age: 46 ± 15 year, range 18-75) were pre-operatively evaluated using the single heel rise (HR) and the first metatarsal rise (FMR) sign tests. Two reviewers graded the PTT tears on a I-III scale and measured the hindfoot valgus angle on the pre-operative MRI of the ankle. Read More

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http://dx.doi.org/10.1016/j.ejrad.2017.12.005DOI Listing
February 2018
10 Reads

[Which foot deformities should be radiologist be familiar with?]

Authors:
E von Stillfried

Radiologe 2018 May;58(5):476-481

Abteilung für Orthopädie, Sektion Kinderorthopädie, Vulpius Klinik Bad Rappenau, Vulpiusstraße 29, 74906, Bad Rappenau, Deutschland.

Most deformities of the foot are visible at birth and can be diagnosed without imaging. They can be divided into congenital flexible, congenital structural and acquired foot deformities. The most common congenital flexible foot deformity in children is the metatarsus adductus, which usually requires no long-term therapy. Read More

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http://dx.doi.org/10.1007/s00117-017-0349-1DOI Listing
May 2018
7 Reads

Medial Double Arthrodesis: Technique Guide and Tips.

J Foot Ankle Surg 2018 Mar - Apr;57(2):364-369. Epub 2017 Dec 15.

Fellowship Co-Director, Fellowship-Trained Foot and Ankle Surgeon, Foot and Ankle Center, Westerville, OH. Electronic address:

The triple arthrodesis procedure remains the historical standard to treat complex hindfoot pathology. However, in recent data, the medial double arthrodesis has been documented to provide similar benefit with decreased complication rates compared with the triple arthrodesis. Therefore, increased interest in this procedure for the treatment of complex hindfoot pathologies has ensued. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S10672516173061
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http://dx.doi.org/10.1053/j.jfas.2017.10.017DOI Listing
September 2018
23 Reads

Whether Flexible Flatfoot Needs the Treatment? An Observation of Plantar Pressure Effects on Adults with Flexible Flatfoot by Wearing over the Counter Insoles When Walking on Level Surface, Upstairs and Downstairs.

J Am Podiatr Med Assoc 2017 Dec 15. Epub 2017 Dec 15.

‡ The First Affiliated Hospital of Xi'an Jiaotong University orthopaedics.

Background: Orthotic insole is one popular physiotherapy for flatfoot. However, the effects and if flexible flatfoot needs the treatment are not clear and how the plantar pressure change while walking upstairs and downstairs had not been studied. This study observed the plantar pressure of different walking condition to find out the answers. Read More

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http://dx.doi.org/10.7547/16-103DOI Listing
December 2017
11 Reads

Influence of tibialis posterior muscle activation on foot anatomy under axial loading: A biomechanical CT human cadaveric study.

Foot Ankle Surg 2017 Dec 20;23(4):250-254. Epub 2016 Jul 20.

Catholic Clinic Mainz, Department of Foot and Ankle Surgery, Mainz, Germany; Friedrich-Schiller University Jena, University Hospital Jena, Department of Trauma, Hand and Reconstructive Surgery, Jena, Germany. Electronic address:

Background: Collapse of the medial longitudinal arch and subluxation of the subtalar joint are common occurrences in adult flatfoot deformity. Controversy exists about the role of the tibialis posterior (TP) tendon as first and/or essential lesion. Subtle changes in the foot configuration can occur under weight bearing. Read More

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http://dx.doi.org/10.1016/j.fas.2016.07.003DOI Listing
December 2017
10 Reads

Pathological kinematic patterns of the tarsal complex in stage II adult-acquired flatfoot deformity.

J Orthop Res 2017 Nov 30. Epub 2017 Nov 30.

Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China.

The in vivo kinematic characteristics of the tarsal joints during gait stance phase were still unclear in adult-acquired foot deformity (AAFD). This study included seven healthy subjects (14 feet) and 12 stage II AAFD patients (14 feet). The 3D models of tarsal bones were reconstructed based on CT scan. Read More

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http://dx.doi.org/10.1002/jor.23821DOI Listing
November 2017
8 Reads

Reported selection criteria for adult acquired flatfoot deformity and posterior tibial tendon dysfunction: Are they one and the same? A systematic review.

PLoS One 2017 1;12(12):e0187201. Epub 2017 Dec 1.

School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia.

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. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0187201PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5711021PMC
December 2017
5 Reads

Study on the foot shape characteristics of the elderly in China.

Foot (Edinb) 2017 Dec 24;33:68-75. Epub 2017 Apr 24.

College of Resources and Environment, Shaanxi University of Science and Technology, Xi'an, China. Electronic address:

Background: With aging, the feet of the elderly above 60 years old in China present degenerative changes, deformities, and diseases, which significantly affect their daily activities.

Objectives: The authors aimed to study the morphological characteristics of the feet and identify the foot type according to size (length and width) and defect characteristics of elderly feet in China.

Methods: A convenient sample of 1000 subjects above 60 years old was recruited mainly in the regions of Shanghai, Shaanxi, Henan, Hebei, and Sichuan in China. Read More

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http://dx.doi.org/10.1016/j.foot.2017.04.004DOI Listing
December 2017
1 Read

The resistance to failure of spring ligament reconstruction.

Foot (Edinb) 2017 Dec 3;33:29-34. Epub 2017 Jun 3.

Medway Maritime Hospital, Gillingham, United Kingdom.

Introduction: The spring ligament (SL) is increasingly recognised as the major structure that fails in acquired adult flatfoot deformity (AAFD). This is the first study that demonstrates integrity of repair of the SL.

Patients And Methods: Six pairs of fresh frozen cadavers were setup in a standardised fashion with ankle in plantargrade (mean age 59 years, BMI 25). Read More

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http://dx.doi.org/10.1016/j.foot.2017.05.006DOI Listing
December 2017
16 Reads

Occupational Outcomes of Reconstructive Surgery for Adult Acquired Flatfoot Deformity.

Mil Med 2017 11;182(11):e2066-e2068

Tripler Army Medical Center, 1 Jarrett White Road, Honolulu, HI 96859.

Introduction: Reconstruction of a symptomatic adult flatfoot is an involved operation with a long recovery period. No previous studies have looked at the occupational or functional results of athletically active patients who have undergone this surgery. In the U. Read More

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http://dx.doi.org/10.7205/MILMED-D-17-00201DOI Listing
November 2017
3 Reads

Porous Titanium Wedges in Lateral Column Lengthening for Adult-Acquired Flatfoot Deformity.

Foot Ankle Spec 2018 Aug 27;11(4):347-356. Epub 2017 Oct 27.

University of Virginia Medical Center, Charlottesville, Virginia.

Lateral column lengthening (LCL) is a common procedure for reconstruction of stage II flexible adult-acquired flatfoot deformity (AAFD). The recent development of porous titanium wedges for this procedure provides an alternative to allograft and autograft. The purpose of this study was to report radiographic and clinical outcomes achieved with porous titanium wedges in LCL. Read More

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http://dx.doi.org/10.1177/1938640017735890DOI Listing
August 2018
11 Reads