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VOLUME 12 , ISSUE 1 ( January-March, 2025 ) > List of Articles

REVIEW ARTICLE

Posterior Tibial Tendon Tendovaginitis to Insufficiency: A Historical and Anatomical Review

James P Henry, James E Henry

Keywords : Adult-acquired flatfoot deformity, Foot and ankle, Orthopedic surgery, Posterior tibial tendon insufficiency, Tendonitis

Citation Information : Henry JP, Henry JE. Posterior Tibial Tendon Tendovaginitis to Insufficiency: A Historical and Anatomical Review. J Foot Ankle Surg Asia-Pacific 2025; 12 (1):2-5.

DOI: 10.5005/jp-journals-10040-1359

License: CC BY-NC 4.0

Published Online: 20-12-2024

Copyright Statement:  Copyright © 2025; The Author(s).


Abstract

Tenosynovitis was first described by Velpeau in 1818. Many others, including de Quervain in 1895, have noted the importance of this common condition and the painful symptoms associated with this pathology around the ankle. In 1936, Dr Kulowski of St Joseph's, Missouri, was the first to publish on posterior tibial tendon (PTT) tendovaginitis (tenosynovitis). Since his initial description of the pathology, the condition has evolved into a complex spectrum of disease termed PTT insufficiency (PTTI). PTTI is the most common cause of adult-acquired flatfoot deformity (AAFD) and affects an estimated 3–10% of the population. The exact etiology of the condition remains unknown.

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  1. Ross MH, Smith M, Plinsinga ML, et al. Self-reported social and activity restrictions accompany local impairments in posterior tibial tendon dysfunction: a systematic review. J Foot Ankle Res 2018;11(1):49. DOI: 10.1186/s13047-018-0292-z
  2. Smyth NA, Aiyer AA, Kaplan JR, et al. Adult-acquired flatfoot deformity. Eur J Orthop Surg Traumatol 2017;27(4):433–439. DOI: 10.1007/s00590-017-1945-5
  3. Kulowski J. Tendovaginitis (tenosynovitis). Miss State Med Assoc 1936;33(4):135–137.
  4. Abousayed MM, Alley MC, Shakked R, et al. Adult-acquired flatfoot deformity: etiology, diagnosis, and management. JBJS Rev 2017;5(8):e7. DOI: 10.2106/JBJS.RVW.16.00116
  5. Henry JK, Shakked R, Ellis SJ. Adult-acquired flatfoot deformity. Foot Ankle Orthop 2019;4(1):2473011418820847. DOI: 10.1177/2473011418820847
  6. Petersen W, Hohmann G, Stein V, et al. The blood supply of the posterior tibial tendon. J Bone Joint Surg Br 2002;84(1):141–144. DOI: 10.1302/0301-620x.84b1.11592
  7. Holmes GB, Mann RA. Possible epidemiological factors associated with rupture of the posterior tibial tendon. Foot Ankle 1992;13(2):70–79. DOI: 10.1177/107110079201300204
  8. Ikpeze TC, Brodell JD, Chen RE, et al. Evaluation and treatment of posterior tibialis tendon insufficiency in the elderly patients. Geriatr Orthop Surg Rehabil 2019;10:215145931882146. DOI: 10.1177/2151459318821461
  9. Myerson M, Solomon G, Shereff M. Posterior tibial tendon dysfunction: its association with seronegative inflammatory disease. Foot Ankle 1989;9(5):219–225. DOI: 10.1177/107110078900900503
  10. Beals TC, Pomeroy GC, Manoli A. Posterior tibial tendon insufficiency: diagnosis and treatment. J Am Acad Orthop Surg 1999;7(2):112–118. DOI: 10.5435/00124635-199903000-00004
  11. Bluman EM, Title CI, Myerson MS. Posterior tibial tendon rupture: a refined classification system. Foot Ankle Clin 2007;12(2):233–249. DOI: 10.1016/j.fcl.2007.03.003
  12. Johnson KA, Strom DE. Tibialis posterior tendon dysfunction. Clin Orthop Relat Res 1989;239:196–206.
  13. Myerson MS, Thordarson DB, Johnson JE, et al. Classification and nomenclature: progressive collapsing foot deformity. Foot Ankle Int 2020;41(10):1271–1276. DOI: 10.1177/1071100720950722
  14. Deland JT. Adult-acquired flatfoot deformity. J Am Acad Orthop Surg 2008;16(7):399–406. DOI: 10.5435/00124635-200807000-00005
  15. Geideman WM, Johnson JE. Posterior tibial tendon dysfunction. J Orthop Sport Physic Ther 2000;30(2):68–77. DOI: 10.2519/jospt.2000.30.2.68
  16. Millar NL, Silbernagel KG, Thorborg K, et al. Tendinopathy. Nat Rev Dis Prim 2021;7(1):1. DOI: 10.1038/s41572-020-00234-1
  17. Adams JE, Habbu R. Tendinopathies of the hand and wrist. J Am Acad Orthop Surg 2015;23(12):741–750. DOI: 10.5435/JAAOS-D-14-00216
  18. Lopez RGL, Jung HG. Achilles tendinosis: treatment options. Clin Orthop Surg 2015;7(1):1–7. DOI: 10.4055/cios.2015.7.1.1
  19. Kaeding C, Best TM. Tendinosis: pathophysiology and nonoperative treatment. Sports Health 2009;1(4):284–292. DOI: 10.1177/1941738109337778
  20. Blood TD, Morrell NT, Weiss APC. Tenosynovitis of the hand and wrist. JBJS Rev 2016;4(3):e7. DOI: 10.2106/JBJS.RVW.O.00061
  21. Griffiths DLl. Tenosynovitis and tendovaginitis. Br Med J 1952;1(4759):645–647. DOI: 10.1136/bmj.1.4759.645
  22. Chin SH, Vedder NB. Stenosing Tenosynovitis. In: Plastic Surgery Secrets Plus. Elsevier; 2010:908–911.
  23. Wakefield RJ, Balint PV, Szkudlarek M, et al. Musculoskeletal ultrasound including definitions for ultrasonographic pathology. J Rheumatol 2005;32(12):2485–2487.
  24. Thompson AR, Plewes LW, Shaw EG. Peritendinitis crepitans and simple tenosynovitis: a clinical study of 544 cases in industry. Occup Environ Med 1951;8(3):150–160. DOI: 10.1136/oem.8.3.150
  25. Flores DV, Mejía Gómez C, Fernández Hernando M, et al. Adult acquired flatfoot deformity: anatomy, biomechanics, staging, and imaging findings. Radiographics 2019;39(5):1437–1460. DOI: 10.1148/rg.2019190046
  26. Schweitzer ME, Karasick D. MR imaging of disorders of the posterior tibialis tendon. Am J Roentgenol 2000;175(3):627–635. DOI: 10.2214/ajr.175.3.1750627
  27. Richie DH. Biomechanics and clinical analysis of the adult acquired flatfoot. Clin Podiatr Med Surg 2007;24(4):617–644. DOI: 10.1016/j.cpm.2007.07.003
  28. Hecht GG, Van Rysselberghe NL, Young JL, et al. Gait analysis in orthopaedic surgery: history, limitations, and future directions. J Am Acad Orthop Surg 2022;30(21):e1366–e1373. DOI: 10.5435/JAAOS-D-21-00785
  29. Ghormley RK, Spear IM. Anomalies of the posterior tibial tendon. AMA Arch Surg 1953;66(4):512–516. DOI: 10.1001/archsurg.1953.01260030527019
  30. de Quervain F. On a form of chronic tendovaginitis by Dr. Fritz de Quervain in la Chaux-de-Fonds. 1895. Am J Orthop (Belle Mead NJ) 1997;26(9):641–644.
  31. Lapidus PW, Seidenstein H. Chronic non-specific tenosynovitis with effusion about the ankle; report of three cases. J Bone Joint Surg Am 1950;32A(1):175–179.
  32. Williams R. Chronic non-specific tendovaginitis of tibialis posterior. J Bone Joint Surg Br 1963;45:542–545.
  33. Trevino S, Gould N, Korson R. Surgical treatment of stenosing tenosynovitis at the ankle. Foot Ankle 1981;2(1):37–45. DOI: 10.1177/107110078100200107
  34. Key JA. Partial rupture of the tendon of the posterior tibial muscle. J Bone Joint Surg Am 1953;35-A(4):1006–1008.
  35. Cozen L. Posterior tibial tenosynovitis secondary to foot strain. Clin Orthop Relat Res 1965;42:101–102.
  36. Kettelkamp DB, Alexander HH. Spontaneous rupture of the posterior tibial tendon. J Bone Joint Surg Am 1969;51(4):759–764.
  37. Norris SH, Mankin HJ. Chronic tenosynovitis of the posterior tibial tendon with new bone formation. J Bone Joint Surg Br 1978;60-B(4):523–526. DOI: 10.1302/0301-620X.60B4.711801
  38. Funk DA, Cass JR, Johnson KA. Acquired adult flat foot secondary to posterior tibial-tendon pathology. J Bone Joint Surg Am 1986;68(1):95–102.
  39. Citron N. Injury of the tibialis posterior tendon: a cause of acquired valgus foot in childhood. Injury 1985;16(9):610–612. DOI: 10.1016/0020-1383(85)90009-9
  40. Mann RA, Thompson FM. Rupture of the posterior tibial tendon causing flat foot. Surgical treatment. J Bone Joint Surg Am 1985;67(4):556–561.
  41. Leach RE, DiIorio E, Harney RA. Pathologic hindfoot conditions in the athlete. Clin Orthop Relat Res 1983;177:116–121.
  42. Jahss MH. Spontaneous rupture of the tibialis posterior tendon: clinical findings, tenographic studies, and a new technique of repair. Foot Ankle 1982;3(3):158–166. DOI: 10.1177/107110078200300308
  43. Goldner JL, Keats PK, Bassett FH, et al. Progressive talipes equinovalgus due to trauma or degeneration of the posterior tibial tendon and medial plantar ligaments. Orthop Clin North Am 1974;5(1):39–51.
  44. Henceroth WD, Deyerle WM. The acquired unilateral flatfoot in the adult: some causative factors. Foot Ankle 1982;2(5):304–308. DOI: 10.1177/107110078200200509
  45. Fried A, Hendel C. Paralytic valgus deformity of the ankle; replacement of the paralyzed tibialis posterior by the peronaeus longus. J Bone Joint Surg Am 1957;39-A(4):921–932.
  46. Myerson MS. Adult acquired flatfoot deformity: treatment of dysfunction of the posterior tibial tendon. Instr Course Lect 1997;46:393–405.
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