Endoscopic Release of Posterior Tibial Tendon Sheath for Stenosing Tenosynovitis of Posterior Tibial Tendon

Stenosing tenosynovitis of the posterior tibial tendon is a cause of posteromedial ankle pain. Conservative treatment is often ineffective, and surgery is usually required for alleviation of symptoms. Stenosis of the tendon sheath can be overcome by release of the tendon sheath or deepening of the retromalleolar groove. These procedures can be performed endoscopically. The purpose of this Technical Note is to describe the technical details of endoscopic release of the posterior tibial tendon sheath with the advantage of minimal soft tissue dissection and titrated tendon sheath release according to the extent of stenosis. Associated tendon pathology and hindfoot malalignment should be treated accordingly.