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The Journal of Bone and Joint Surgery 81:1173-82 (1999)
© 1999 The Journal of Bone and Joint Surgery, Inc.

Current Concepts Review

Current Concepts Review - Acquired Flatfoot in Adults Due to Dysfunction of the Posterior Tibial Tendon*

GREGORY C. POMEROY, M.D.{dagger}, SOUTH PORTLAND, MAINE, R. HOWARD PIKE, M.D.{ddagger}, ATLANTA, GEORGIA, TIMOTHY C. BEALS, M.D.§, SALT LAKE CITY, UTAH and ARTHUR MANOLI, II, M.D.#, MOBILE, ALABAMA


   Introduction
 
Dysfunction of the posterior tibial tendon is increasingly recognized as an etiology leading to acquired flatfoot in adults. Increased awareness of this condition during the past fifteen years has resulted in intensive study of the basic science and pathophysiology behind this clinical syndrome. New regimens for clinical assessment and treatment have been developed. Although much progress has been made in the recognition and treatment of this condition, many controversies and unanswered questions remain. This article will review the current thinking with regard to the pathophysiology, clinical evaluation, and decision-making process for the treatment of this common, debilitating condition.


   History
 
Kulowski, in 1936, was the first, to our knowledge, to describe tenosynovitis of the posterior tibial tendon39. Almost twenty years later, Fowler discussed tibialis posterior syndrome and described a series of patients who had had operative treatment of that condition19. In 1963, Williams described the operative treatment of tenovaginitis of . . . [Full Text of this Article]


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