Leg Length Discrepancy and Posterior Tibial Tendon Dysfunction

NewsBot · Feb 13, 2014

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Association Between Leg Length Discrepancy and Posterior Tibial Tendon Dysfunction
Jose Antônio Veiga Sanhudo, Joao Luiz Ellera Gomes
Foot Ankle Spec February 12, 2014

Background. Leg length discrepancy (LLD) is associated with a variety of orthopaedic disorders and biomechanical gait changes that involve possible overload of the posterior tibial tendon (PTT). In view of the biomechanical disturbances induced by LLD, an association may exist between LLD and PTT dysfunction (PTTD).

Purpose. To compare the frequency and magnitude of LLD between subjects with and without PTTD and ascertain whether associations exist between clinical features and presence of dysfunction. Study Design. Case–control study. Methods. A total of 118 patients with a diagnosis of PTTD were seen between January 2009 and September 2012 and compared with 118 gender-matched and race-matched volunteers. The frequency of LLD, the mean absolute LLD, and the mean relative LLD were measured by conventional (radiographic) or computed tomography scanography and compared between cases and controls.

Results. The prevalence of LLD and mean absolute and relative LLD values were significantly greater in the case group (94.9%, 5.64 mm and 7.36%, respectively) than in the control group (79.7%, 3.28 mm and 4.18%, respectively) (P < .001).

Conclusion. The findings of this study demonstrate a relationship between LLD and PTTD. In light of the major biomechanical changes it induces, LLD may be a predisposing factor for development of PTTD.
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Admin2 · Feb 13, 2014

Related threads:
Other thread tagged with posterior tibial tendon dysfunction
Other threads tagged with leg length differences

Craig Payne · Feb 16, 2014

Thanks to IanG for getting the full paper to me while on the road.

This study is largely nonsensical. It was a case control study. The cases were older than the controls and BMI was higher in the cases than the controls --> both are potential confounders in the cause of PTTD --> no matter what the results, they can not be relied upon!

As for a plausible mechanism for an association between PTTD and LLD; they found PTTD in the longer leg in 41% and in the shorter leg in 43%!!!! - that kinda defeats the whole claim of what they allegedly found in the study!

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