Tibialis Posterior Tendon Dysfunction
Classification
- Continuum of dysfunction from tenosynovitis to rupture
- Classification is not predictive & ignores contracted gastroc
Modified Johnson & Strom 1989
- Stage 1: Pain & swelling
- medial aspect foot & ankle
- Tendinitis with mild degeneration tendon
- no deformity
- mobile hindfoot
- Able to perform single limb heel raise
- Stage 2: Dynamic defomity
- Tendon torn & limb weak
- Unable to perform single heel raise
- Midfoot pronation & forefoot abduction
- (dynamic deformity, corrigible)
- Subtalar joint mobile
- Stage 3: Fixed deformity
- Degeneration of tendon
- Deformity fixed (hindfoot valgus)
- ± lateral impingement pain
- Stage 4: Degenerative Changes (modified)
- Valgus angulation of talus & early ankle joint Osteoarthritis