I'm after some info regarding Tibialis Anterior tendon rupture. A client presented 8 days after feeling something "snap" when rushing to the car. Initial x-rays taken by the hospital showed no problem. I referred back to his GP with recommendation of further scans which apparently showed the Tib Ant tendon has torn off the bone.
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What is the likelyhood of surgical intervention and if so, what is the chance of a full recovery?
His GP has referred to a surgeon and his appointment is one month after initial injury - is there an urgent need to bring this appt forward?
Thea Lawson
via Hazel!
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Will put in a few calls and see what I can wrangle! Given that it is almost 2 weeks post injury, would the tendon have already retracted fully into the leg?
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Thanks Kevin. Thea is contacting our local orthopaedic surgeon as I type this email.
Hazel -
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Surgical repair of acute and chronic tibialis anterior tendon ruptures.
Sammarco VJ, Sammarco GJ, Henning C, Chaim S.
J Bone Joint Surg Am. 2009 Feb;91(2):325-32.
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Over the last 9 months, I have repaired 2 acute and one old Tib Ant. rupture. In all cases the tendon had retracted under the superior extensor retinaculum. I all cases, I lengthened the tendon at the myotendinous junction from 4-12 cm. The tendon was re-attached under physiologic tension to its insertion. NWB 6 weeks, PT at 3 weeks and FWB in a AFO by 8 weeks. The AFO was DC'd after 3 months. All patients had 4+/5 strength returned, no pain and no tendon graft was used.
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Creative x 1 - List
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Jeff: My orthopedic surgeon says he may have to do a graft to repair my severed ATT; would you be willing to comment on how you repaired your ruptured ATTs without grafts? thanks...
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Sure: as part of the repair, the edges of the torn tendon need to be removed/debrided to a fresh, healthy surface. If the amount of damaged tendon removed is excessive in length (>2 cm), something needs to be done to make up the missing length. I prefer to lengthen the tendon rather than sacrifice a normal tendon or use cadaver graft (dead tendon) to accomplish this task. I lengthen the anterior tibial tendon in the front of the leg near the shin bone. It is right under the skin and very easy to get at. Best of luck!!!
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I trained in the Bay area and know many of the guys there. Tom Chang is in the San Rafel area and Steve Paladino is in East Bay. Dee, every surgeon has their preference for surgical repair of a particular problem; so I can't guarantee that they would use this method. I know they are both highly compentent and very well trained and respected. So if either one recommended a graft, it will be done perfectly! Otherwise, you may be making a trip to Philly...lol...Best of Luck.
Jeff Siegel, DPM, FACFAS -
The Operative Treatment of the Degenerative Rupture of the Anterior Tibialis Tendon.
Schneppendahl J, Gehrmann SV, Stosberg U, Regenbrecht B, Windolf J, Wild M.
Z Orthop Unfall. 2009 Nov 12. [Epub ahead of print]
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Surgical outcome following tibialis anterior tendon repair.
Ellington JK, McCormick J, Marion C, Cohen BE, Anderson RB, Davis WH, Jones CP.
Foot Ankle Int. 2010 May;31(5):412-7.
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The operative treatment of the degenerative rupture of the anterior tibialis tendon
Schneppendahl J, Gehrmann SV, Stosberg U, Regenbrecht B, Windolf J, Wild M.
Z Orthop Unfall. 2010 May;148(3):343-7.
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Repair of Lacerated Anterior Tibial Tendon with Acellular Tissue Graft Augmentation
Lawrence A. DiDomenico, Gregory A. Blasko, Laurence Cane, Davina J. Cross
Journal of Foot and Ankle Surgery (in press)
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Gait Analysis after Tibialis Anterior Tendon Rupture Repair Using Z-Plasty
Jürgen Goetz, MD, Johannes Beckmann, MD, PhD, Franz Koeck, MD, PhD, Joachim Grifka, MD, PhD, Silvia Dullien, Guido Heers, MD, PhD
Journal of Foot and Ankle Surgery; Article in Press
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Traumatic tibialis anterior tendon rupture: treatment with a two-stage silicone tube and an interposition hamstring tendons graft protocol
Vasileios Kontogeorgakos, et al
Knee Surgery, Sports Traumatology, Arthroscopy; June 2013
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Bad Spelling x 1 - List
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Reconstruction using an autograft with near complete preservation of the extensor retinaculum for chronic tibialis anterior tendon disruption
Youichi Yasui, Masato Takao, Wataru Miyamoto, Takashi Matsu****a
Archives of Orthopaedic and Trauma Surgery; September 2013
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Chronic Tibialis Anterior Tendon Tear Treated With an Achilles Tendon Allograft Technique
Ezequiel Palmanovich, MD; Yaron S. Brin, MD; Lior Laver, MD; Dror Ben David, MD; Sabri Massrawe, MD; Meir Nyska, MD; Iftach Hetsroni, MD
Orthopedics; November 2013 - Volume 36 · Issue 11: 850-853
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Minimally Invasive Repair of the Tibialis Anterior Tendon Using a Semitendinosus Autograft.
Michels F, Van Der Bauwhede J, Oosterlinck D, Thomas S, Guillo S.
Foot Ankle Int. 2013 Dec 20
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Tibialis anterior tendon rupture as a complication of first tarsometatarsal joint steroid injection: A case report and review of literature
Kowshik Jainc, Mehek Asad, Yogesh Joshi, Asad Syed
The Foot: June 11, 2015
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Soft tissue repair for tibialis anterior tendon ruptures using plate and screw fixation technique in combination with anterolateral thigh flaps transplantation.
Mao H, Xu G
J Orthop Surg Res. 2015 Sep 17;10(1):143.
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Complete Rupture of the Tibialis Anterior Tendon Due to Intratendinous Ganglion Cyst
Seok Hyun Kweon, M.D., Ph.D., Hong Je Kang, M.D., Ph.D., and Seoung In Lee, M.D.
J Korean Orthop Assoc. 2015 Oct;50(5):412-417
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Repair of Chronic Tibialis Anterior Tendon Rupture With a Major Defect Using Gracilis Allograft
Alex Burton, Umur Aydogan
Foot Ankle Spec January 7, 2016
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Repair of Chronic Tibialis Anterior Tendon Ruptures.
Funk SS, Gallagher B, Thomson AB.
Orthopedics. 2016 Mar 9:1-5
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Rupture of the tendon of the tibialis anterior muscle : Etiology, clinical symptoms and treatment
Waizy H et al
Unfallchirurg. 2017 Oct 4. doi: 10.1007/s00113-017-0417-z
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Acute rupture of the tibialis anterior tendon
Gómez-Canedo JM
Acta Ortop Mex 2017; 31 (5)
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Zancolli Technique for Delayed Repair of Tibialis Anterior Tendon Rupture: A Case Report and Literature Review.
Valisena S et al
Foot Ankle Spec. 2018 Jan 1:1938640017751539. doi: 10.1177/1938640017751539
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Management of Isolated Anterior Tibial Tendon Rupture: A Systematic Review and Meta-Analysis
Anthony Tickner et al
JFAS; Article in Press
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Management of Tibialis Anterior Tendon Rupture: Recommendations based on the Literature Review
Amir RezaVosoughiaGavinHeyesbAndrew P.MolloycLyndon W.MasondAmir HumanHoveidaeie
Foot and Ankle Surgery; 21 June 2019
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I
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Surgical treatment of tibialis anterior tendon rupture
Jens KurtJohansen et al
Foot and Ankle Surgery; 9 September 2020
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Risk Factors for Anterior Tibial Tendon Pathology
Matthew M. Levitsky, MD, Christina E. Freibott, BS, Justin K. Greisberg, MD, ...
Foot & Ankle International October 14, 2020
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Management of Anterior Tibialis Tendon Ruptures
Chen, Jie MD, MPH; Kadakia, Rishin MD; Akoh, Craig Chike MD; Schweitzer, Karl Martin Jr MD
Journal of the American Academy of Orthopaedic Surgeons: July 1, 2021
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Reconstruction of chronic tibialis anterior tendon ruptures using a free anterior half of a peroneus longus tendon autograft: A technical note
Sung Jae Kim et al
J Orthop Surg (Hong Kong). Jan-Apr 2022;30(1):10225536221083044
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Tibialis Anterior Tendon Rupture Surgical Treatments and Outcomes: A Systematic Review and Meta-Analysis
Keegan A Duelfer et al
J Foot Ankle Surg. 2023 Mar 22;S1067-2516(23)00017-0
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Treatment of a subcutaneous tibialis anterior tendon rupture with a semitendinosus autograft
Hassan Zmerly et al
Acta Biomed. 2023 Jun 23;94(S2):e2023086
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