Is advanced imaging necessary before surgical repair

Is Advanced Imaging a Must in the Assessment of Progressive Collapsing Foot Deformity?

Advanced imaging modalities have, in very recent years, enabled a considerable leap in understanding progressive collapsing foot deformity, evolving from a simple confirmation of clinical diagnostic using basic measurements to minute understanding of soft tissue and bone involvements. MRI and weight-bearing cone-beam computed tomography are enabling the development of new 3-dimensional measurement modalities. The identification of key articular and joint markers of advanced collapse will allow surgeons to better indicate treatments and assess chances of success with conservative therapies and less invasive surgical procedures, with the hope of improving patient outcomes.

Comparison of preoperative MRI and intraoperative findings of posterior tibial tendon insufficiency

Background

The purpose of this study was to investigate the radiological and surgical correlation between preoperative magnetic resonance images (MRI) and the intraoperative findings in patients with acquired adult flatfoot.

Results

The overall radiological–surgical correlation between preoperative MRI and the intraoperative findings for posterior tibial tendon insufficiency was only slight to fair in our patient’s series. Comparing the most commonly used posterior tibial tendon classification systems, the classification of Rosenberg et al. and Kong et al. showed higher interobserver agreement than our modified classification system and the classification system of Conti et al.

Conclusion

Further prospective studies are needed to evaluate the importance of preoperative MRI before surgical repair of posterior tibial tendon dysfunction.

Flexor Digitorum Longus Tendon Transfer and Modified Kidner Technique in Posterior Tibial Tendon Dysfunction

The modified Kidner procedure and flexor digitorum longus tendon transfer are common procedures used today when addressing posterior tibial tendon dysfunction. These techniques are often used in conjunction with a combination of osteotomies to correct flatfoot deformity, and have been proved to be reliable and predictable.