Question
I want to thank you for answering my previous posts about continued problems stemming from adult acquired flexible flat flat foot following a modified kinder.  I want to update you about what I finally did.

I am now three weeks post op posterior tibial tendon repair (with tendon transfer) spring ligament repair, cotton and medial calcaneal osteomety and lengthening of the Achilles tendon.  I decided to go with the foot and ankle orthopedist who specializes in posterior tibial disfunction at one of the top ranked orthopedic hospitals.  

This is the summary of the MRI done 8 weeks ago

MRI of the left ankle demonstrates flatfoot deformity with profound degeneration of the posterior tibial tendon between the medial malleous and navicular attachment with marked scarring of the parantendon but relative preservation of the remaining long medial flexor tendons.  Supermedial fibers of the spring ligament are thickened.  The inferior fibers appear chronically disrupted and encased in hypertrophic synovium.  Two discrete osteopchondral lesions are seen over the talar dome, the largest of which is noted medially, with mild subchondral collapse and areas of high grade cartilage loss.

I find it amazing that an MRI from one year earlier showed that there was mild tearing by the insertion of the ptt and the navicular with a normal spring ligament.  One year later both my posterior tibial tendon and spring ligament were profoundly degenerated (partially ruptured)
The surgeon said that the posterior tibial tendon was only attached to the navicular by a few strands.  I still have 5 weeks non weight bearing followed by about three months in a cam walker and then PT.  Of course it is too early to determine the outcome of this surgery.  The doctor said that the 4 1/2 hour surgery went very well.  I spoke to two people who had a similar combination of procedures done by the same surgeon.  One had the surgery 11 years ago and the other, 5 years ago.  Both said that they are still doing very well and are back with their life and doing all of the activities that they had done before developing pain related to flexible flat foot.  I am hoping that I will be able to say the same thing in a year or two

Answer
Hi Amy,

Thanks for the update on your foot.  It sounds like you made a good choice and that this doctor really addressed the actual deformity. This should provide you with better long-term results.

Good Luck

Sincerely,

Marc Katz, DPM
Tampa, FL
Advanced Podiatry
http://www.thetampapodiatrist.com
http://www.tampacryosurgery.com
http://katzpodiatristtampa.blogspot.com
http://painfoot.blogspot.com
http://twitter.com/TampaPodiatrist
http://www.notoenailfungus.com
http://www.vibranttampatoenails.com

DISCLAIMER:
This information is offered as free advice and as general information. It may not be applicable to the specific questioner and his/her problem.  It is not based on actual knowledge of the questioner or his/her medical history and it cannot and should not be relied upon as definitive medical opinion or advice.  Reliable medical opinion and advice can only be obtained through hands-on physical contact and exam of the patient to establish an accurate diagnosis and treatment plan.  No doctor/patient relationship is created or established here and may not be inferred through answers on this site.  The questioner and other readers must consult his/her own doctor before proceeding or implementing any suggestions contained within this document and answers on this site.  The questioner is only to act upon his/her own doctor抯 orders and recommendations. By reading this posting which follows, the reader fully understands and confirms that he/she holds harmless this writer. If this is not fully agreeable to you, the reader, and/or you have not attained the age of 18 years, you hereby are advised to read no further.