TATT ORAL Presentation at SLOA annual academic session in 2021.pptx

Clinical and Radiological outcomes of Tibialis Anterior Tendon Transfer.
Presented at SLOA annual academic session in 2021

1. EVALUATION OF CLINICAL AND RADIOLOGICAL OUTCOME FOLLOWING TIBIALIS ANTERIOR TENDON TRANSFER IN RELAPSED CONGENITAL CLUBFOOT SN Marasinghe , D Tennakoon, SR Wijayasinghe , S Hewavitharana , AA Kishan THE SRI LANKA ORTHOPAEDIC ASSOCIATION. 12 TH ANNUAL ACADEMIC SESSIONS 2020

2. INTRODUCTION CLUB FOOT/ CONGENITYAL TALEPUS EQUINO-VARUS (CTEV) Overall incidence 1:1,000. Male: Female ratio approximately 2:1 50% bilateral. Primary treatment is the Ponseti method. Causes for relapses, Poor brace wearing compliance Neuromuscular problems Atypical clubfoot

3. OBJECTIVES Evaluation of clinical outcome following TATT in relapsed congenital clubfoot Evaluation of radiological outcome following TATT in relapsed congenital clubfoot.

4. MATERIALS AND METHODS Retrospective study N = 15 patients with relapse congenital clubfoot (a total of 27 feet) CTEV patients who have undergone Tibialis Anterior Tendon Transfer. Age = 4 - 12 years (Mean age = 7.4 years ).

5. Clinical outcome - Laaveg-Ponseti system* Pain Function Satisfaction ROM ankle and foot Alignment of the hindfoot and forefoot Walking ability SCORES RESULTS 90 -100 Excellent 80-89 Good 70-79 Fair <70 Poor * Reproduced by Laaveg et al. ASSESSMENT – CLINICAL OUTCOME

6. Radiological outcome Pre and Post-op. AP talocalcaneal angle talo-1 st -metatarsal angle LAT talo-1 st-- metatarsal angle calcaneo-tibial angle ASSESSMENT – RADIOLOGICAL OUTCOME

7. RESULTS - CLINICAL OUTCOME

8. RESULTS- PERSONAL SATISFACTION

9. RESULTS- FUNCTION

10. RESULTS- PAIN

11. RESULTS-RADIOLOGICAL OUTCOME The following box plots show the difference of before and after sample measurements of each variable. To understand the significance of these differences, Friedmann test was used.

12. RESULTS-RADIOLOGICAL OUTCOME P>0.05 P>0.05 P>0.05 P>0.05 Since the Friedman test indicates that the groups are significant, a pairwise  Wilcoxon signed-rank tests  was applied to identify which groups are different. The results indicate that before and after measurements are not significant at 5% significance level.

13. DISCUSSION Use of Laaveg - Ponseti system for clinical assessment. Necessity of a Prospective study. Lager sample for data collection. Planned pre-operative and post operative imaging and data collection .

14. CONCLUSION TATT is an excellent method of treating stiff residual clubfoot deformity when considering the clinical outcome even though there is no significant radiological improvement in pre and post-operative radiographs.

15. REFERENCES

16. THANK YOU….