Posterior Tibial Tendon Dysfunction: An Overview

Samuel Ka-Kin Ling*, Tun Hing Lui
Department of Orthopaedics and Traumatology, North District Hospital, Hong Kong SAR

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Creative Commons License
© 2017 Samuel Ka-Kin Ling and Tun Hing Lui.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at Department of Orthopaedics & Traumatology, North District Hospital, 9 Po Kin Road, Sheung Shui, Hong Kong SAR, Tel: +26838888, Fax: +26838028, E-mails:



Adult acquired flatfoot deformity is a commonly seen condition with a large clinical spectrum. It ranges from asymptomatic subjects to severely disabled arthritic patients. Posterior tibialis tendon dysfunction is a common cause of adult acquired flatfoot deformity.


This article systematically reviews the published literature from books and journals that were either originally written or later translated into the English language regarding the subject of posterior tibialis tendon dysfunction.


Posterior tibialis tendon dysfunction is a primary soft tissue tendinopathy of the posterior tibialis that leads to altered foot biomechanics. Although the natural history of posterior tibialis tendon dysfunction is not fully known, it has mostly been agreed that it is a progressive disorder. While clinical examination is important in diagnosing adult acquired flat-feet; further investigation is often required to delineate the different aetiologies and stage of the disease. The literature describes many different management choices for the different stages of posterior tibialis tendon dysfunction.


Because of the wide range of symptom and deformity severity, surgical reconstruction is based on a-la-carte. The consensus is that a plethora of reconstructive options needs to be available and the list of procedures should be tailored to tackle the different symptoms, especially when managing complex multi-planar reconstructions.

Keywords: Flatfoot, Adult acquired flatfoot deformity, Posterior tibial tendon dysfunction, Posterior tibial tendon insufficiency, Posterior tibial tendon, Pes planus, Calcaneovalgus, Foot arch.