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Outcome of Surgical Treatment of Medial Tibial Stress Syndrome

Yates, Ben FCPod(S); Allen, Mike J. FRCS; Barnes, Mike R. BSc

Journal of Bone & Joint Surgery - American Volume: October 2003 - Volume 85 - Issue 10 - p 1974–1980
Scientific Article

Background: Medial tibial stress syndrome is a common chronic sports injury characterized by exercise-induced pain along the posteromedial border of the tibia. The reported outcomes of surgical treatment of this condition have varied.

Methods: Of seventy-eight patients who underwent surgery for medial tibial stress syndrome, forty-six (thirty-one men and fifteen women) returned for follow-up. The outcomes of the surgery were determined by comparing preoperative and postoperative pain levels as indicated on a visual analog pain scale and ascertaining the ability of the athletes to return to presymptom levels of exercise.

Results: The mean duration of postoperative follow-up was thirty months (range, six to sixty-three months). Surgery significantly reduced pain levels (p < 0.001) by an average of 72% as indicated on the visual analog pain scale. An excellent result was achieved in 35% of the limbs; a good result, in 34%; a fair result, in 22%; and a poor result, in 9%. Despite the success with regard to pain reduction, for a variety of reasons only nineteen (41%) of the athletes fully returned to their presymptom sports activity.

Conclusions: Surgery can significantly reduce the pain associated with medial tibial stress syndrome. Despite this reduction in pain, athletes should be counseled that a full uninhibited return to sports is not always achieved.

Level of Evidence: Therapeutic study, Level IV (case series [no, or historical, control group]). See Instructions to Authors for a complete description of levels of evidence.

Ben Yates, FCPod(S); University College Northampton, Boughton Green Road, Northampton NN2 7AL, United Kingdom. E-mail address:

Mike J. Allen, FRCS; Mike R. Barnes, BSc; Department of Sports Medicine, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, United Kingdom

Copyright 2003 by The Journal of Bone and Joint Surgery, Incorporated
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