What Is Posterior Tibial Tendon Repair?
Posterior tibial tendon repair is a surgery performed to repair an injured or torn posterior tibial tendon. The tear may occur as a result of a fall or break/dislocation of the ankle. The surgery may also be performed for chronic inflammation of the posterior tibialis tendon due to overuse.
The posterior tibial tendon is a cord of strong fibrous tissue. It passes through the ankle to attach the calf muscle with the bones of the midfoot. It provides stability to the arch and supports the foot while walking. Inflammation or a tear of this tendon as a result of injury may cause dysfunction, leading to pain and the development of flatfoot. Posterior tibial tendon repair can help relieve painful symptoms and restore normal foot and ankle function.
Indications for Posterior Tibial Tendon Repair
Posterior tibial tendon repair is recommended for treatment of the following conditions:
- Posterior tibial tendon dysfunction
- Flatfoot, also known as “fallen arches” or “pes planus”
- Posterior tibial tendon injury or rupture
You may also need posterior tibial tendon repair if any of the following apply to you:
- Your symptoms have lasted for more than six months
- You have significant loss of function and weakness in the foot
- You are an athlete and wish to return to sports soon
- Non-surgical treatments have failed to alleviate symptoms
Preparation for Posterior Tibial Tendon Repair
In general, preoperative preparation for posterior tibial tendon repair will involve the following steps:
- A thorough examination is performed by your doctor to check for any medical issues that need to be addressed prior to surgery.
- Depending on your medical history and age, you may need to undergo bloodwork and imaging tests to screen for any abnormalities that could threaten the safety of the procedure.
- You will be asked if you have allergies to medications, anesthesia, or latex.
- You should inform your doctor of any medications, vitamins, or supplements that you are taking.
- You should refrain from taking supplements or medications such as blood thinners, aspirin, or anti-inflammatory medicines, for one to two weeks prior to surgery.
- You should refrain from consuming alcohol or tobacco at least a week before surgery.
- You should not consume solids or liquids at least eight hours prior to surgery.
- You will need to arrange for someone to drive you home after surgery.
- Written consent will be obtained from you after the surgical procedure has been explained in detail.
Surgical Treatment Options for Posterior Tibial Tendon Dysfunction in Fort Worth and Weatherford, TX
Posterior tibial tendon dysfunction in its early stages may be treated with rest, cold packs, immobilization, physical therapy, steroid injections, and anti-inflammatory medication. Shoe inserts that support the arch may be recommended. Surgery may be necessary if conservative treatments fail and may include:
Tenosynovectomy
The inflamed tissue lining the tendon is removed.
Tendon Transfer
The damaged tendon is replaced by another foot tendon.
Arthrodesis
In cases where arthritis has developed, the bones are realigned and fused to form a single bone by removing cartilage.
Osteotomy
Bones of the heel and midfoot may be cut to recreate the arch of the foot.
Kidner Procedure
An unnecessary bone called the accessory navicular is removed from the inner side of the foot if it is causing pain.
Procedure for Posterior Tibial Tendon Repair
Posterior tibial tendon repair may be performed as an open surgery, where a large incision is made, or a minimally invasive arthroscopic surgery, where small incisions are made to insert an arthroscope (a thin tube with a camera and light source) and miniature surgical tools.
In general, the procedure involves the following steps:
- You will lie on your back on the operating table under general or spinal anesthesia.
- A long surgical cut is made through the skin and muscle of your lower calf.
- The underlying muscles are carefully separated to expose the damaged posterior tibial tendon.
- Your surgeon then makes an incision through the sheath that surrounds the tendon and repairs or removes sections of the damaged tendon.
- In some instances, where the tendon has been severely damaged, your surgeon may take out another tendon from your foot and use it to replace all or a section of the severely damaged tendon.
- After accomplishing adequate repair of the tendon, the overlying soft tissue and skin around your calf are closed with sutures, and sterile bandages are applied.
Postoperative Care and Recovery
In general, postoperative care instructions and recovery after posterior tibial tendon repair will involve the following steps:
- You will be transferred to the recovery area, where your nurse will closely observe you for any allergic/anesthetic reactions and monitor your vital signs as you recover.
- Your ankle will be immobilized in a splint for a specified period of time to protect the ankle and facilitate healing.
- You may notice some pain and discomfort in the operated-on area. Pain and anti-inflammatory medications are provided as needed.
- Antibiotics are also prescribed to address the risk of surgery-related infection.
- Keep the foot elevated at or above the level of your heart to help minimize swelling and discomfort.
- Do not bear weight on the operated-on leg. A walking boot or a non-weight-bearing cast is recommended for a few weeks to support the foot.
- Assistive devices such as crutches and walkers are recommended to maintain balance and stability while walking for several weeks.
- Start rehabilitation (physical therapy) as recommended by your surgeon to improve your range of motion. You should begin appropriate exercises to stretch and strengthen the foot and ankle muscles.
- Keep the surgical site clean and dry. Instructions on surgical site care and bathing will be provided.
- You can resume most of your normal activities in four months’ time. However, refrain from strenuous activities and lifting heavy weights for at least six months or longer. Gradual increase in activities over a period of time is recommended.
- A return to sports is recommended only when the foot has regained its normal strength and function, provided that you have your doctor’s approval.
- A periodic follow-up appointment will be scheduled to monitor your progress.
Risks and Complications
Posterior tibial tendon repair is a relatively safe procedure; however, as with any surgery, some risks and complications may occur, such as the following:
- Infection
- Bleeding
- Damage to nerves and blood vessels
- Thromboembolism or blood clots
- Anaesthetic/allergic reactions
- Calf muscle weakness
- Persistent foot and ankle pain
Why Choose Dr. Gary Driver for Posterior Tibial Tendon Repair in Fort Worth and Weatherford, TX?
Finding a reliable doctor with the right treatment approach is essential to recovering from posterior tibial tendon damage. Here’s why Dr. Gary Driver is your best option:
Advanced Treatment Techniques
Dr. Gary Driver uses the latest surgical techniques to facilitate recovery and promote long-term tendon health. His patients can opt for minimally invasive surgery to reduce scarring and experience accelerated healing.
Patient-Centered Care
Every individual is unique, which means that treatment needs to be adapted to accommodate a variety of needs. Dr. Gary Driver takes the time to understand the concerns of each patient he works with and create a tailored treatment plan.
Convenient Locations
Dr. Gary Driver operates in two convenient locations: Fort Worth and Weatherford. You can receive treatment at whichever clinic is closest to you—no need for a long drive to access medical care.
Fellowship-Trained Foot and Ankle Surgeon
Dr. Gary Driver is a fellowship-trained foot and ankle surgeon. His experience and advanced training enable him to provide effective treatment while ensuring patient safety.
Contact Dr. Gary Driver for Posterior Tibial Tendon Repair in Fort Worth and Weatherford, TX
Having a damaged posterior tibial tendon can prevent you from doing the things you enjoy and even cause you to miss work. Failing to seek treatment in time can lead to further complications, negatively impacting your quality of life. Fortunately, Dr. Gary Driver provides comprehensive surgical and non-surgical care for posterior tibial tendon damage. Schedule an appointment today and take a step closer to making a full recovery.
Frequently Asked Questions
How much does posterior tibial tendon repair cost in Fort Worth and Weatherford, TX?
The cost of posterior tibial tendon repair will depend on the severity of your condition and your insurance coverage. Dr. Gary Driver will provide you with a cost estimate after your initial appointment.
Does insurance cover posterior tibial tendon repair?
Insurance coverage for posterior tibial tendon repair depends on your insurance policy. It may be covered if it is deemed medically necessary, but the extent of coverage can vary. You should contact your insurance provider for more details.
Can posterior tibial tendonitis come back after surgery?
Yes, it’s possible for surgery to fail and for the condition to come back. However, the chances of this happening are minimal.