Tibialis Posterior Surgery

Heel osteotomy & tendon transfer

  • The tibialis posterior tendon is a major “guy rope” to the inside of your foot and the longitudinal arch.
  • This tendon no longer works and your foot has therefore collapsed.
  • The heel drifts out to the side and the arch is now flat.
  • It is possible to correct your foot surgically and this will consist of an operation in two parts.
  • Firstly, on the heel and secondly, on the tendon.
  • The heel operation would either involve cutting the heel bone and moving it to the inner side or correcting it through the joint if this turns out to be arthritic.
  • The tendon will be reconstructed through a separate incision on the inside of the foot and borrowing a tendon that controls some of the toe movements.
  • You would be in hospital for approximately two to four days and you will have a plaster. This will be changed at two weeks when the wounds will be checked to ensure there are no healing problems.
  • At six weeks after surgery the plaster will be removed and a protective boot worn for six weeks. Once the boot has been removed you will be required to wear an orthotic (insole) to support your foot.
  • You will not be bearing weight through the foot in the first six weeks but will take weight through the boot between six and twelve weeks.
  • The potential advantages are that you will have a stable foot with hopefully no pain, but you may have some ongoing awareness of minor discomfort in the foot.
  • The potential complications include infection, nerve injury, failure of the bone to heal and persisting pain. Overall, I believe you have an 85% chance of a good result, a 10% chance of a result with improvement but still symptoms, which are somewhat annoying, and a 5% chance of persisting pain which is troublesome.