Question
I was dx with patella femoral syndrome (increased Q angle, patella alta, lateral tilt, lateral tracking 20 years ago. I currently have grade 3-4 arthritic changes in both knees. Two years ago, I was dx with posterior tibial tendonitis which did not respond to conservative treatments. I had an accessory navicular and adult acquired flexible flat feet. A modified kinder was performed but unfortunately about 8 months after the surgery, my arch completely collapsed, my ankle started tilting increasingly towards the floor and my pain symptoms got progressively worse. I recently had an extensive flat foot reconstruction (Achilles tendon lengthening, ptt repair/tendon transfer, spring ligament repair and cotton and calcaneal osteotomies. A few days ago, I was given the go ahead to do partial weight bearing. Prior to the surgery, when I stood, my toes pointed out (too many toes sign). It was a real effort to stand with my foot pointing straight ahead and when I forced my foot to point straight ahead, I felt pulling in my knee. My ankle also collapsed in when I stood. Now my toes point straight ahead (hopefully a sign that the surgery will end up being successful).

I was wondering if the newly corrected foot mechanics may result in slowing the progression of arthritis in my knee?

Could the knee issues have caused the foot problems or could the foot mechanics be the underlying cause of knee problems?

Thank you in advance for answering my questions

Answer
It is certainly a hopeful sign.  Breakdown and instability in the mechanics of your foot certainly can and does put undue pressure on the knee, which can cause it to break down and become arthritic.  It certainly is not the only cause of knee arthritis but it does make sense.

As you continue to rehabilitate, you should have a better idea of the long term outlook for the knee.  I hope it goes well!

All the best,
Andrew Schneider, DPM

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