Posterior Tibial Tendon Reconstruction: What is it?
A tendon in the back of the foot and ankle has torn or stretched out
This tendon is responsible for maintaining the arch of the foot
When the tendon ruptures, the arch of the foot becomes flat, and no support is present on the
inside of the ankle.
It is not possible to repair the torn tendon, and a new tendon must replace the torn one.
In order to improve the arch of the foot, and protect the tendon transfer, something else has to
be done to the back of the foot because the tendon transfer is not strong enough to support the
foot and keep it corrected
There are a number of additional procedures that can be performed (many times with a
minimally invasive technique) in order to straighten and strengthen the foot.
Not all of these are done, although usually, one or more are necessary for a successful surgery.
These include a cut on the heel bone (calcaneus osteotomy), a lengthening of the Achilles
tendon, or a bone cut in the middle of the foot (a cuneiform osteotomy).
Flatfoot Reconstruction - Postoperative Recovery
You will not be walking on the leg for between 2 and 6 weeks depending on the added procedures
are done since the timing of walking depends on what exactly is done at the surgery
In order to stay off your foot, you will need to use crutches, a walker, a wheelchair or a
scooter-type device called a roll-about.
There will be a hard plaster bandage applied to the leg for two weeks after surgery
Your first follow-up visit will be at approximately 2 weeks
We will usually apply a removable boot for you to wear at this time
If the surgery is on your left ankle, you should be able to drive an automatic vehicle at two
weeks. If the surgery is on the right foot, you may drive between 3 and 4 weeks.
Physical therapy is very helpful to regain the strength and movement of the ankle
You should plan to use a physical therapist for about 1-2 months
There will be moderate swelling of the foot, ankle, and leg for about 6 months
You will continue to improve your strength and movement for about 9 months after the surgery
You can expect to have some soreness and aching for about 4-6 months after surgery
Flatfoot Reconstruction - Specific Post-Operative Course
Week 0-2
Foot wrapped in bulky plaster bandage, ice, elevate, take pain medication
No walking on the surgical extremity
Week 2-6
First follow-up in the office, X-rays taken, dressing changed
The boot is applied to the foot, and weight-bearing, as tolerated, maybe permitted depending on
which procedures were performed
6-8 Weeks
Full weight in the boot, start physical therapy
By 8 weeks you remove the boot and go into a brace that fits in the shoe for one month
