Non-surgical management of tibialis posterior insufficiency

The literature contains many studies assessing the surgical management of Tibialis Posterior Insuciency (TPI), but there is a paucity of published work on its conservative treatment. In our institution, 32 feet in 28 patients were treated conservatively for TPI. There were 21 males and 7 females with a median age of 60 years. They were staged according to the modified Johnson and Strom system, and were reviewed clinically by an independent assessor using the AOFAS ankle/hindfoot scale. The median follow-up was 24 months. All but five patients reviewed were satisfied with the outcome of their treatment and only one (stage 1) has requested surgery.