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Tibialis posterior tendon debridement Surgical Technique

Overview

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CPD/CME Points: 0.5

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In the appropriately selected patient a Tibialis posterior tendon debridement and repair will provide a very effective (and rapid) means of both halting  symptoms and also possibly progression of the tendon degeneration. It is used in the main for patients with symptomatic grade 1 tendinosis according to the classification system of Johnson & Strom. In other words no functional lengthening of the tendon with the ability to perform a single heel rise still preserved.

A stripping of the paratenon and targeted, limited incisions into all areas of degenerative change is followed by a variable period of non-weight-bearing in cast. This may be as short as two weeks, followed by three to four weeks in a post-operative boot and loading the tendon.

A return to full function is the norm in patients with non-inflammatory conditions as the cause.

Late deterioration is in my experience an uncommon event after an initially successful surgical intervention.

 

Author: Mark Herron FRCS

Institution: The Wellington Hospital , London

 

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