This article is part of the supplement: 1st Congress of the International Foot & Ankle Biomechanics (i-FAB) community

Keynote presentation

Advances in biomechanics of posterior tibial tendon dysfunction and flatfoot deformity

Harold B Kitaoka

• Correspondence: Harold B Kitaoka kitaoka.harold@mayo.edu

Author Affiliations

Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA

Journal of Foot and Ankle Research 2008, 1(Suppl 1):K1 doi:10.1186/1757-1146-1-S1-K1

The electronic version of this article is the complete one and can be found online at: http://www.jfootankleres.com/content/1/S1/K1

Published:

26 September 2008

© 2008 Kitaoka; licensee BioMed Central Ltd.

Introduction

The objective of this presentation is to highlight the clinical and laboratory-based research related to posterior tibial tendon dysfunction (PTTD).

Methods and results

• Defining the flatfoot: clinical, foot pressure, radiologic

• Critical evaluation of flatfoot deformity: in vitro

• How often does the flatfoot occur?

• Normal arch development

• Why is the flatfoot a problem?

• Why does the flatfoot occur?

○ 1. Effects of weightbearing [1]

○ 2. Lost of static support [2]

○ 3. Loss of dynamic support [3]

○ 4. Anatomic predisposition

○ 5. Joint subluxation

• Causes of flatfoot in adults

○ 1. Posterior tibial tendon dysfunction (PTTD)

○ 2. Arthritis: Midfoot, hindfoot, ankle

○ 3. Hypermobile flatfoot

○ 4. Neuropathic arthropathy

○ 5. Fracture malunion

○ 6. Inflammatory arthropathy

○ 7. Peroneal spastic flatfoot

○ 8. Neuromuscular disorder

○ 9. Other

• PTTD etiology

• PT muscle, tendon anatomy

• PT function

• PT muscle activity during gait

• Factors predisposing to PTTD

○ PT gliding resistance

• PT pathoanatomy

• Natural history of PTTD

• PTTD evaluation: symptoms, signs

• Investigative studies

• Gait analysis in PTTD patients

• Simulated walking: Normal, PTTD [4]

• PTTD treatment

• PTTD treatment results

• Failures, complications

Conclusion

• Current recommendations

Acknowledgements

Kai-Nan An, PhD; Kenton R Kaufman, PhD

References