Adult acquired flat foot deformity: The joint-preserving procedures in stage II tibialis posterior tendon dysfunction

Abstract

INTRODUCTION: The adult acquired flat foot (AAFF) deformity is a chronic debilitating condition commonly associated with dysfunction of the posterior tibial tendon (PTT). It is often missed unless it is associated with a generalised medical condition such as rheumatoid arthritis. Surgical management is indicated when conservative treatment fails. The joint-preserving procedures have evolved over the years and are preferred for the flexible, non-arthritic deformity. MATERIALS AND METHOD: Twenty-two patients were included in this prospective study. The mean age was 59.8 years with the majority being female. The average BMI was 28.7. The inclusion criterion was symptomatic AAFF deformity due to stage II PTT dysfunction RESULTS: Twenty patients were available for follow-up at one year. The mean AOFAS post-operative score of 89 was significantly improved from the pre-operative score of 42 (p value = <0.001). Likewise most of the radiographic parameters also improved significantly. The complication rate was very low CONCLUSION: This prospective study shows that the joint-preserving procedures for AAFF deformity due to stage II PTT dysfunction are an effective and preferable option to arthrodesis. There is a low complication rate with high patient satisfaction. A certain amount of training and expertise though, is required. Level 2 study.