Management of Isolated Anterior Tibial Tendon Rupture: A Systematic Review and Meta-Analysis

Publication date: Available online 13 December 2018Source: The Journal of Foot and Ankle SurgeryAuthor(s): Anthony Tickner, Seiha Thorng, Mary Martin, Valerie MarmolejoAbstractRupture of the tibialis anterior tendon is a rare condition reported to occur most often spontaneously in patients>45 years of age. Diagnosis is often delayed due to transient pain at the time of rupture and the ability of the long extensors to compensate for the lost action of the tibialis anterior. Treatment has been proposed to be based on the activity level of the individual; however, no consensus has been reached on the optimal treatment modality for this rare condition. A systematic review and meta-analysis were performed to determine outcomes obtained with conservative and surgical management. Twenty-four references (155 cases) were identified. Conservative management (21 cases, 13.55%) was associated with poorer outcomes (odds ratio [OR] 0.68; I2 = 61%) because of pain and functional limitations related to ankle dorsiflexory weakness. Surgical intervention (134 cases, 86.45%) had a better chance for good outcome (OR 8.40; I2 = 63%). Use of an ipsilateral split/turn-down ipsilateral tibialis anterior tendon graft (OR 32.15; I2 = 0%) semitendinous autograft (OR 15.25; I2 = 44%), or direct repair (OR 12.57; I2 = 0%) provided the best postoperative outcomes, whereas extensor hallucis longus autograft was associated with the worst (OR 0.27, I2 = 34%). The most common postopera...
Source: The Journal of Foot and Ankle Surgery - Category: Orthopaedics Source Type: research