Tibialis posterior as a cause of AAFD - ‘Not guilty your honour’

Chandra Pasapula, David Chrastek, Sajid Sharriff, Zeinab Ibrahim-Hashi, Steven Cutts


Recent changes in the perception of the primary lesion responsible for the pathogenesis of adult acquired flatfoot deformity (AAFD) has emerged. Studies question the essential role of the tibialis posterior (TP) and demonstrate its absence does not necessarily lead to planovalgus. The significant role the static restraints play, specifically the spring ligament (SL), its contribution to the medial arch stability, and how its failure precipitates AAFD, are increasingly recognised. It is now addressed as part of the treatment planning [1, 2, 3]. This article aims to evaluate new and existing theories that allow us to draw these conclusions.


foot and ankle, posterior tibial tendon dysfunction, spring ligament, adult acquired flatfoot deformity, plantar calcaneonavicular ligament, medial longitudinal arch

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