Biomechanical Evaluation of Circumtibial and Transmembranous Routes for Posterior Tibial Tendon Transfer for Dropfoot

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dc.contributor.authorWagner, Emilio
dc.contributor.authorWagner, Pablo
dc.contributor.authorZanolli, Diego
dc.contributor.authorRadkievich, Rubén
dc.contributor.authorRedenz, Gunther
dc.contributor.authorGuzmán, Rodrigo
dc.date.accessioned2022-05-02T21:36:26Z
dc.date.available2022-05-02T21:36:26Z
dc.date.issued2018
dc.description.abstractBackground: Tibialis posterior tendon transfer is performed when loss of dorsiflexion has to be compensated. We evaluated the circumtibial (CT), above-retinaculum transmembranous (TMAR), and under-retinaculum transmembranous (TMUR) transfer gliding resistance and foot kinematics in a cadaveric foot model during ankle range of motion (ROM). Methods: Eight cadaveric foot-ankle distal tibia specimens were dissected free of soft tissues on the proximal end, applying an equivalent force to 50% of the stance phase to every tendon, except for the Achilles tendon. Dorsiflexion was tested with all of the tibialis posterior tendon transfer methods (CT, TMAR, and TMUR) using a tension tensile machine. A 10-repetition cycle of dorsiflexion and plantarflexion was performed for each transfer. Foot motion and the force needed to achieve dorsiflexion were recorded. Results: The CT transfer showed the highest gliding resistance (P < .01). Regarding kinematics, all transfers decreased ankle ROM, with the CT transfer being the condition with less dorsiflexion compared with the control group (6.8 vs 15 degrees, P < .05). TMUR transfer did perform better than TMAR with regard to ankle dorsiflexion, but no difference was shown in gliding resistance. The CT produced a supination moment on the forefoot. Conclusion: The CT transfer had the highest tendon gliding resistance, achieved less dorsiflexion and had a supination moment. Clinical Relevance We suggest that the transmembranous tibialis posterior tendon transfer should be the transfer of choice. The potential bowstringing effect when performing a tibialis posterior tendon transfer subcutaneously (TMAR) could be avoided if the transfer is routed under the retinaculum, without significant compromise of the final function and even with a possible better ankle range of motion.es
dc.description.versionVersión Publicadaes
dc.identifier.citationWagner E, Wagner P, Zanolli D, Radkievich R, Redenz G, Guzman R. Biomechanical Evaluation of Circumtibial and Transmembranous Routes for Posterior Tibial Tendon Transfer for Dropfoot. Foot Ankle Int. 2018 Jul;39(7):843-849. doi: 10.1177/1071100718760845. Epub 2018 Mar 12. PMID: 29528722.es
dc.identifier.urihttps://doi.org/10.1177/1071100718760845es
dc.identifier.urihttp://hdl.handle.net/11447/6043
dc.language.isoenes
dc.subjectTibialis posterior tendon transferes
dc.subjectCircumtibiales
dc.subjectTransmembranouses
dc.subjectInterosseous membranees
dc.subjectParalytic footes
dc.subjectDropfootes
dc.titleBiomechanical Evaluation of Circumtibial and Transmembranous Routes for Posterior Tibial Tendon Transfer for Dropfootes
dc.typeArticlees
dcterms.sourceFoot & Ankle Internationales

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