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What can I Expect from Surgery for Flat Feet?

By H. Colledge
Updated Mar 03, 2024
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In flat feet, the arch on the inner side of each foot, which raises the bottom of the foot from the ground, is very low or completely absent. If other treatments fail, surgery for flat feet may be necessary. An operation could involve reconstructing a diseased tendon to support the arch, or, in the case of advanced arthritis, fusing together bones in the foot. Surgery for those with flat feet normally requires a stay in the hospital, and pain, swelling, and bleeding may be experienced following the operation. A cast is fitted after surgery and weight can usually be placed on the foot after about six weeks.

Sometimes flat feet occur naturally, causing no problems, but in other cases they result from disease, in which case there is generally pain and stiffness, and one side may be affected more than the other. The arch of the foot develops during childhood. In some people this does not happen, but the feet, while flat, are often quite flexible, and do not need treatment. When flat feet occur later in life, this can be the result of arthritis or a problem with the tibialis posterior tendon, a strong band of tissue that provides arch support. If measures such as exercises, special shoes or insoles, and painkilling medication fail to reduce symptoms, flat feet surgery might be required.

Where flat feet are caused by problems with the tibialis posterior tendon, surgery could involve reconstruction of the tendon. If flat feet are due to advanced arthritis, a different type of operation may be required, where bones in the foot and, in severe cases, the ankle, are fused together to make the foot more stable. Left untreated, a diseased tibialis posterior tendon can go on to cause arthritis, making fusion surgery necessary.

In surgery for flat feet where the tibialis posterior tendon is reconstructed, the diseased tendon is cut away and replaced with another tendon nearby. A special screw is used to fix the replacement tendon to bone. The operation may be carried out under local or general anesthetic and usually requires a hospital stay. Patients rest in bed, with the foot raised, for around a week following the operation.

Where severe arthritis leads to surgery for flat feet, a procedure known as triple fusion may be carried out. Sometimes this is combined with ankle fusion, if arthritis has progressed to involve the ankle joint. During fusion surgery for flat feet, after cutting away diseased areas, several bones in the foot are joined together using metal screws. The bones then fuse together as healing takes place.

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Discussion Comments

By anon1003056 — On Apr 20, 2020

I had the flat foot surgery in October 2018. Things progressed exactly as described by the doctor for the first 3 months except for the edema that wouldn't go away. Its now been 20 months and I am still having issues with the edema. My ankle is in a constant state of pain. I tried the TIMS device to get rid of the edema and it did nothing!

Recently, I have been using an over the counter ankle brace to wear for everything except for sleeping. The brace keeps the swelling down but if I go one day without it, the swelling returns and the pain along with it. Had I known that the edema (swelling) would have not gone away, I would not have had the surgery.

I've learned to walk differently and have had knee problems since the surgery. I have had significant sciatic nerve pain during the recovery as well. My life is not better after the surgery. I simply exchanged one pain for a different pain, and walking is still difficult.

If I walk more than 1/2 mile, my ankle swells up. If I work on my feet too much, my ankle swells up. I have no issues with the other foot but the surgically repaired foot has never gotten better. For the last 16 months, I have been walking down the stairs backwards because the strength never returned to my foot. I would have been better off to cut it off and have a prosthetic.

By turquoise — On Jun 25, 2012

@simrin-- Yes, this surgery is not a very common one and it might take some searching to find a skilled surgeon who has experience with it. We live in New York and we are lucky to have several such doctors here.

If I remember correctly, my dad's surgeon said that the success rate is around forty to forty-five percent. But if you work with a surgeon who is experienced in this area, I think the success rate is higher.

But you have to keep in mind that even after surgery, you have to take it easy. You can't be extremely active and engage in demanding sports as that might affect recovery and health of your foot. You should wear protective equipment as necessary, as well as special shoes for flat feet. So the surgeon is definitely important, but so is how you take care of yourself afterward.

By SteamLouis — On Jun 25, 2012

@turquoise-- Thanks for sharing your dad's experience. I have severe arthritis in my feet and have been considering this surgery for some time. The problem is that there really isn't a specialist that is experienced with this surgery in my area. My doctor is unwilling to do it as he has no experience and he says that the success rate for this surgery is really low.

It sounds like your dad had the surgery done by an experienced doctor. Did you have to search for a while to find that surgeon?

Also, what did your dad's surgeon say the success rate for this surgery is?

As of right now, I don't think I will go ahead with the surgery. If I can find an experienced surgeon who can guarantee an acceptable success rate, then I will go for it. I have a lot of foot problems and flat feet pain right now. But I don't want to have surgery if it's not going to help.

By turquoise — On Jun 24, 2012

My father had flat foot surgery almost a year ago because of a diseased tendon. His tendon was removed, lengthened and attached to another one. The surgery went fine, he was under general anesthesia and woke up when it was all over.

The recovery was the most challenging part because he couldn't work for a while. He was in a regular cast for a little over a month and then in aircast supports for just as long. He was actually really good at following his doctor's directions and took it really easy during recovery. He didn't push himself physically and was extra careful.

After about five months post-surgery, he was more active than he was before the surgery. He now takes walks every day and is able to stand on his feet for a long time without pain. He is really happy that he got the surgery.

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