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The Journal of Bone and Joint Surgery (American) 85:1974-1980 (2003)
© 2003 The Journal of Bone and Joint Surgery, Inc.

Scientific Article

Outcome of Surgical Treatment of Medial Tibial Stress Syndrome

Ben Yates, FCPod(S), Mike J. Allen, FRCS and Mike R. Barnes, BSc

Investigation performed at Leicester General Hospital, Leicester, United Kingdom

Ben Yates, FCPod(S)
University College Northampton, Boughton Green Road, Northampton NN2 7AL, United Kingdom. E-mail address: ben.yates{at}northampton.ac.uk

Mike J. Allen, FRCS
Mike R. Barnes, BSc
Department of Sports Medicine, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, United Kingdom

The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

Background: Medial tibial stress syndrome is a common chronic sports injury characterized by exercise-induced pain along the posteromedial border of the tibia. The reported outcomes of surgical treatment of this condition have varied.

Methods: Of seventy-eight patients who underwent surgery for medial tibial stress syndrome, forty-six (thirty-one men and fifteen women) returned for follow-up. The outcomes of the surgery were determined by comparing preoperative and postoperative pain levels as indicated on a visual analog pain scale and ascertaining the ability of the athletes to return to presymptom levels of exercise.

Results: The mean duration of postoperative follow-up was thirty months (range, six to sixty-three months). Surgery significantly reduced pain levels (p < 0.001) by an average of 72% as indicated on the visual analog pain scale. An excellent result was achieved in 35% of the limbs; a good result, in 34%; a fair result, in 22%; and a poor result, in 9%. Despite the success with regard to pain reduction, for a variety of reasons only nineteen (41%) of the athletes fully returned to their presymptom sports activity.

Conclusions: Surgery can significantly reduce the pain associated with medial tibial stress syndrome. Despite this reduction in pain, athletes should be counseled that a full uninhibited return to sports is not always achieved.

Level of Evidence: Therapeutic study, Level IV (case series [no, or historical, control group]). See Instructions to Authors for a complete description of levels of evidence.


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