Foot & Ankle Care

The average person walks more than 125,000 miles in a lifetime. Walking this distance over the course of a lifetime requires a person’s feet to be strong and stable.

Posterior Tibial Tendonitis Surgery

Foot & Ankle Specialists At Wisconsin Bone & Joint

The physicians at Wisconsin Bone & Joint utilize cutting-edge technology to assess, diagnose and work with patients to develop innovative treatment plans for a variety of foot and ankle conditions and injuries. Our team of physicians are committed to providing you with the best treatment options to alleviate your foot and ankle pain.

Providing trusted Orthopedic care in the community for over 40+ years

At Wisconsin Bone and Joint, we pride ourselves with providing you highly personalized and comprehensive orthopedic care. Our philosophy of direct physician-to-patient care means your physician will be an intrical part of every stage of your care. This commitment to a dedicated continuum-of-care model has made us one of the most trusted and respected practices in Southeast Wisconsin and greater Milwaukee area.

Posterior Tibial Tendonitis Surgery

What Is Posterior Tibial Tendonitis Surgery?

Surgical Treatment

Surgery should only be done if the pain does not get better after 6 months of appropriate treatment. The type of surgery depends on where tendonitis is located and how much the tendon is damaged. Surgical reconstruction can be extremely complex. The following is a list of the more commonly used operations. Additional procedures may also be required.

Gastrocnemius Recession or Lengthening of the Achilles Tendon
This is a surgical lengthening of the calf muscles. It is useful in patients who have limited ability to move the ankle up. This surgery can help prevent flatfoot from returning, but does create some weakness with pushing off and climbing stairs. Complication rates are low but can include nerve damage and weakness. This surgery is typically performed together with other techniques for treating flatfoot.

Tenosynovectomy (Cleaning the Tendon)
This surgery is used when there is very mild disease, the shape of the foot has not changed, and there is pain and swelling over the tendon. The surgeon will clean away and remove the inflamed tissue (synovium) surrounding the tendon. This can be performed alone or in addition to other procedures. The main risk of this surgery is that the tendon may continue to degenerate and the pain may return.

Tendon Transfer
Tendon transfer can be done in flexible flatfoot to recreate the function of the damaged posterior tibial tendon. In this procedure, the diseased posterior tibial tendon is removed and replaced with another tendon from the foot, or, if the disease is not too significant in the posterior tibial tendon, the transferred tendon is attached to the preserved (not removed) posterior tibial tendon.

One of two possible tendons are commonly used to replace the posterior tibial tendon. One tendon helps the big toe point down and the other one helps the little toes move down. After the transfer, the toes will still be able to move and most patients will not notice a change in how they walk.

Although the transferred tendon can substitute for the posterior tibial tendon, the foot still is not normal. Some people may not be able to run or return to competitive sports after surgery. Patients who need tendon transfer surgery are typically not able to participate in many sports activities before surgery because of pain and tendon disease.

Osteotomy (Cutting and Shifting Bones)
An osteotomy can change the shape of a flexible flatfoot to recreate a more “normal” arch shape. One or two bone cuts may be required, typically of the heel bone (calcaneus).

If flatfoot is severe, a bone graft may be needed. The bone graft will lengthen the outside of the foot. Other bones in the middle of the foot also may be involved. They may be cut or fused to help support the arch and prevent the flatfoot from returning. Screws or plates hold the bones in places while they heal.

Fusion
Sometimes flatfoot is stiff or there is also arthritis in the back of the foot. In these cases, the foot will not be flexible enough to be treated successfully with bone cuts and tendon transfers. Fusion (arthrodesis) of a joint or joints in the back of the foot is used to realign the foot and make it more “normal” shaped and remove any arthritis. Fusion involves removing any remaining cartilage in the joint. Over time, this lets the body “glue” the joints together so that they become one large bone without a joint, which eliminates joint pain. Screws or plates hold the bones in places while they heal.

Side-to-side motion is lost after this operation. Patients who typically need this surgery do not have a lot of motion and will see an improvement in the way they walk. The pain they may experience on the outside of the ankle joint will be gone due to permanent realignment of the foot. The up and down motion of the ankle is not greatly affected. With any fusion, the body may fail to “glue” the bones together. This may require another operation.

Our team is here for you

When conservative care and treatment is appropriate, we offer the best, least invasive, least aggressive treatment options to relieve your pain and discomfort. When an injury is more serious and conservative care is not an option, our orthopedic surgeons provide the latest in innovative surgical interventions available with the goal of getting you back to the life you love. Wisconsin Bone & Joint physicians offer orthopedic services at three convenient locations in Mayfair, Glendale and Cedarburg.