Flat feet? Did you have surgery?

leebee

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Sep 14, 1999
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I fell in December and landed SMACK on my knee, and it's been a nightmare since then. The x-rays and MRI show that I need a total knee replacement. However, the ortho claims that the TKR won't be effective unless I have my fallen arch repaired also. I believe him; I saw the xrays, understand the extent of bowing in my leg and the knee displacement because of the way my foot rolls inward and my ankle presses in and down. I am waiting for an appointment with the foot doc, so of course I've been consulting Dr. Google in the meantime. The surgical repair of my arch is scary-sounding stuff, including 2-3 months completely non-weight-bearing, off my feet in a cast from knee to toes. Everything I've read also says it's painful. i was just wondering if anyone has had fallen arches repaired, and how did it go for you? I'm not going to let myself be scared away from the surgery, but man... it sounds pretty intense. If anyone here has any experience with this, I'd like to hear how it went for you.
 
I haven’t but a lady I know has. She’s about 50. She seems to be doing well now. She was off work for several months I believe (she’s a nurse).
 
Sorry this is happening, I wonder though, didn't the Dr suggest shoes, slippers and footwear?
 
Yes, I had it done in February 2021. I had two osteotomies, an achilles lengthening, and a bunion fixation thrown it (because it actually is part of the flat foot). It was a long recovery, but I will tell you this: I did not need a knee replacement to begin with but I'd have occasional knee pain. That is ALL gone. I do still have issues with my foot. Realize this is a major "bone" surgery so it will never be 100% perfect, but I'd do it again. My other foot is flat and I am in the middle of PT for knee and hip pain so there is a relationship for sure. If you want to DM me to talk further without boring the board, please do. It's super important to find the right surgeon on this.
 

Oh my!
That is serious surgery!

Wish you the best for total adjustment
 
I don't have flat feet, but I did have surgery to correct an issue that would lead to flat feet. I had an extra navicular bone that would have caused the arch to collapse if it wouldn't have been removed. There were other issues with the navicular bone that couldn't have been treated correctly without the removal.

I broke the extra navicular bone at the start of a race (triathlon) when someone pushed me forward and I fell of the boat ramp and my foot got lodged in between the ramp and a rock. I did the entire race not knowing the foot was broken. In fact, when I went in a week later, the doctor said it was arthritis causing the pain so he sent me to physical therapy. The PT said it wasn't arthritis but something else so he sent me to an orthopedic surgeon.

By the time I got to the surgeon, the posterior tibial tendon was stuck in the broken navicular bone and being shredded. The surgeon removed the extra bone, reshaped the tendon, shaved off half of the real navicular bone because it was still too large, and drilled holes in it to reattach the tendon.

I was non-weight bearing for 3 months and in a walking boot for another 2 months. They did send me home in a full leg cast for the first two weeks. Ask if they will do that for you.

Unfortunately, I can't tell you about the pain level because I don't have a normal pain tolerance. I was prescribed 50 Percocet and at the appointment to remove the surgical cast, I asked the doctor what I should do with the extra. She told me I shouldn't have any extra because the surgery I had is very painful because it involved shaving the bone and restructuring that area of my foot. I had 47 l remaining. They made me sick, and I can go to a different part of my brain to relieve pain.

After the surgery insist on physical therapy. Because your feet will be immobilized for a long time, you will need PT to regain range of motion. My PT basically had to help my foot remember how to walk correctly.
 
I have been told that I need the surgery on my right foot and I suspect I now need it on both. I was prescribed orthotics and use those for now. The surgeon told me that even after surgery I will not be able to walk/run for exercise, wear fun shoes/boots or walk barefoot. So I asked him why would I then have the surgery and he told me at some point the pain will be so bad I will be desperate for it. I have not reached that point yet. I think if it meant that I could do those other things I would do it, but for now as long as I use the orthotics, the pain is mostly manageable (a day at Disney is tough).
 
@LuvOrlando I have tried orthotics or special footwear in the past but cannot tolerate them; they throw out my knee and cause pain. I have been wearing crocs for probably 25 years because they are the only shoe that doesn't cause cramping and pain all up my leg and into my back when I wear them; I even wore crocs to DD's wedding because regular shoes are that awful for me.

@monsterkitty How did you manage non-weight bearing? Were you allowed to use crutches/walker as long as you didn't put weight on the foot, or were you completely off your feet? I'm having trouble wrapping my head around this part of it.

Waiting for my referral to the foot-dude, as DH calls the foot doctor, is making me unfocused. I'm not scared of surgery, I just don't like not having answers to my questions. Which will happen first- the TKR or the foot surgery? What is the recovery time for either, how long will I be out of work or off my feet, how will we manage PT for one without raising issues with the other, etc. I have 9+ weeks of sick time saved up so YAY, and also yay that I have short-term and long-term disability, but we can't live for a long time with my salary cut to 60%. I know I'm worrying about things that might not happen but it's still distracting. Anyhow.. thanks for the good wishes from everyone, and if anyone has answers or more experiences to share, hopefully you'll post them!
 
20230319_180005 (1).jpg

am on day 12 post-surgery. While my issue is not fallen arches, my rebuild was very extensive. This is actually my second rebuild on my right foot (and have had my left foot done too)

My surgeon removed all of my previous hardware and installed all new stuff. I have a new "foot dude" for this recent surgery and he is doing things a little differently than the previous guy. For the last two, I was non-weight bearing in giant wrapped splint for 12 days and then went to a removable boot but still non-weight bearing for four weeks and then in a walking boot for four weeks, The new guy will be putting me in a hard case from the knee down on Friday and I will be in that for a month (non-weight bearing).

For all of these, I have been using a combination of crutches (I am really bad at crutches), a knee scooter, and an ECV. I returned to work (mostly desk job) as soon as the splint came off and I could shower daily (day 13). This time, I
took 17 days just because of how the calendar worked out. I am a little nervous because my new job is much more physical but I will adapt.

Like Monstorkitty, I have an unusual response to pain. I probably could have used the Oxycodone the first night but not so much for pain as to manage my body's reaction to coming off the anesthesia. The pharmacy was actually out of Oxy so I didn't end up taking any and I have been fine. I have felt a few dull aches in my foot bones every once in a while but it has not been unbearable.

The biggest challenge I have had is the non-weight bearing (NWB). If I spend too much time on the knee scooter, my right hamstring fatigues and my back starts to hurt. Getting up and down from the toilet and chairs is a challenge as well.
 
I used crutches. At the time I had my surgery, knee scooters were very expensive. We did borrow a wheelchair from a friend that I used if we went somewhere that a lot more walking was needed.

Crutches just made more sense to me because my classroom had stairs (risers at it was the band and orchestra room) and wheels wouldn't have worked. At home I used the crutches going up the stairs but scooted on my butt on the way down.

My biggest piece of advice is to listen to the doctor about elevating your foot. I was only given 10 days off from school because there were no instrumental music subs. When I got back into the classroom, it was impossible to keep my foot elevated and the swelling was extreme. Add in an incredible hot classroom, and it was not pleasant.
 
View attachment 747991

am on day 12 post-surgery. While my issue is not fallen arches, my rebuild was very extensive. This is actually my second rebuild on my right foot (and have had my left foot done too)

My surgeon removed all of my previous hardware and installed all new stuff. I have a new "foot dude" for this recent surgery and he is doing things a little differently than the previous guy. For the last two, I was non-weight bearing in giant wrapped splint for 12 days and then went to a removable boot but still non-weight bearing for four weeks and then in a walking boot for four weeks, The new guy will be putting me in a hard case from the knee down on Friday and I will be in that for a month (non-weight bearing).

For all of these, I have been using a combination of crutches (I am really bad at crutches), a knee scooter, and an ECV. I returned to work (mostly desk job) as soon as the splint came off and I could shower daily (day 13). This time, I
took 17 days just because of how the calendar worked out. I am a little nervous because my new job is much more physical but I will adapt.

Like Monstorkitty, I have an unusual response to pain. I probably could have used the Oxycodone the first night but not so much for pain as to manage my body's reaction to coming off the anesthesia. The pharmacy was actually out of Oxy so I didn't end up taking any and I have been fine. I have felt a few dull aches in my foot bones every once in a while but it has not been unbearable.

The biggest challenge I have had is the non-weight bearing (NWB). If I spend too much time on the knee scooter, my right hamstring fatigues and my back starts to hurt. Getting up and down from the toilet and chairs is a challenge as well.
Hoping you feel better soon. No fun.
 
^^ this. And an ice pack behind the knee - it really does help the first couple of days
Ice is the key!

If you can. rent an ice maker. Here local medical equipment rental stores will rent them to you. You can also buy one on Amazon. I had my surgery in 2010 and wasn't able to get my hands on an ice machine or I would have taken it to school with me for my classroom.
 
I have been told that I need the surgery on my right foot and I suspect I now need it on both. I was prescribed orthotics and use those for now. The surgeon told me that even after surgery I will not be able to walk/run for exercise, wear fun shoes/boots or walk barefoot. So I asked him why would I then have the surgery and he told me at some point the pain will be so bad I will be desperate for it. I have not reached that point yet. I think if it meant that I could do those other things I would do it, but for now as long as I use the orthotics, the pain is mostly manageable (a day at Disney is tough).

I don't know specifically what procedures your doctor would do on you (maybe a fusion??), but I can walk/jog for exercise, I can wear a fun shoe on my "new" foot if I want (it's my unoperated foot that doesn't do well), and I can walk barefoot. That said, I don't do those things for the most part because I don't want to do anything to the foot by wobbling on a heel or something like that.

I participate in a group of people who've had or need this surgery, and unless something went wrong with the surgery, most patients are getting back to doing some of what they did when they were younger. One woman is running marathons even. Some are hiking quite a bit.
 
@LuvOrlando I have tried orthotics or special footwear in the past but cannot tolerate them; they throw out my knee and cause pain. I have been wearing crocs for probably 25 years because they are the only shoe that doesn't cause cramping and pain all up my leg and into my back when I wear them; I even wore crocs to DD's wedding because regular shoes are that awful for me.

@monsterkitty How did you manage non-weight bearing? Were you allowed to use crutches/walker as long as you didn't put weight on the foot, or were you completely off your feet? I'm having trouble wrapping my head around this part of it.

Waiting for my referral to the foot-dude, as DH calls the foot doctor, is making me unfocused. I'm not scared of surgery, I just don't like not having answers to my questions. Which will happen first- the TKR or the foot surgery? What is the recovery time for either, how long will I be out of work or off my feet, how will we manage PT for one without raising issues with the other, etc. I have 9+ weeks of sick time saved up so YAY, and also yay that I have short-term and long-term disability, but we can't live for a long time with my salary cut to 60%. I know I'm worrying about things that might not happen but it's still distracting. Anyhow.. thanks for the good wishes from everyone, and if anyone has answers or more experiences to share, hopefully you'll post them!

@leebee, I did the non-weight bearing for 8 weeks. I barely used the crutches because I was horribly clumsy with them and weak upper body. I did best with the knee scooter. I don't know how I would have coped without it. They may or may not be an option for your knee is very sensitive. I had a very think sherpa pad on my knee seat and I was fine, but some people are very sensitive.
 
@leebee, I did the non-weight bearing for 8 weeks. I barely used the crutches because I was horribly clumsy with them and weak upper body. I did best with the knee scooter. I don't know how I would have coped without it. They may or may not be an option for your knee is very sensitive. I had a very think sherpa pad on my knee seat and I was fine, but some people are very sensitive.
I agree about the upper body strength statement and I meant to come back and add more but forgot. Thanks Christine for the reminder!

As a swimmer, my upper body strength was key in using the crutches. It also helped that I was in really good shape because my left hamstring was responsible for keeping my foot up behind me as I crutched through the day. What also helped was that I could do one-legged squats when I needed to use the bathroom. You'll understand when you need to use the restroom.

I'm lucky like those in Christine's group in that I can still do long distance triathlons. I do have some nerve damage from the surgery, so if I have to swim in cold water it can become an issue.

leebee, if you can, try and get the grip bars installed in your bathroom before you have surgery. It will making going to the bathroom so much easier if you have something that you can hold onto while getting on and off the toilet.
 
I don't know specifically what procedures your doctor would do on you (maybe a fusion??), but I can walk/jog for exercise, I can wear a fun shoe on my "new" foot if I want (it's my unoperated foot that doesn't do well), and I can walk barefoot. That said, I don't do those things for the most part because I don't want to do anything to the foot by wobbling on a heel or something like that.

I participate in a group of people who've had or need this surgery, and unless something went wrong with the surgery, most patients are getting back to doing some of what they did when they were younger. One woman is running marathons even. Some are hiking quite a bit.
I don’t recall the exact name of the procedure, but it was not a fusion. The surgeon described an extensive reconstruction of the foot due to flat feet. At the time I had three younger daughters involved in lots of activities and a husband who traveled for weeks at a time for work. My right foot was the issue and not being able to drive/be non weight bearing for 3 months was also a huge roadblock. My youngest just got her driver’s license 2 weeks ago so it might be time to revisit the issue. Possibly things have changed as to what is possible now as well. Thank you—your post actually gives me a bit of hope about this.
 
I don’t recall the exact name of the procedure, but it was not a fusion. The surgeon described an extensive reconstruction of the foot due to flat feet. At the time I had three younger daughters involved in lots of activities and a husband who traveled for weeks at a time for work. My right foot was the issue and not being able to drive/be non weight bearing for 3 months was also a huge roadblock. My youngest just got her driver’s license 2 weeks ago so it might be time to revisit the issue. Possibly things have changed as to what is possible now as well. Thank you—your post actually gives me a bit of hope about this.
Good to hear it wasn't the fusion--that's usually reserved for when the foot is collapsed so badly that it can't be reconstructed. For reference, I had a calcaneal osteotomy (where they shift the heel a few bits to the inside of the foot), and Evan's osteotomy (also called a lateral column lengthening). This is where they inserted a piece of cadaver bone in side the bone on the outside of the heel to make the outside of the foot longer as it tends to shorten with a flat foot. The other procedure done at the same time was an achilles/gastrocnemius lengthening. This shortens in a flat footed person and then exacerbates the condition. Finally, I had a Lapidus bunionectomy. A lot of people think of those as cosmetic but my surgeon wouldn't do the whole thing without it as that all feeds into the arch functionality.

Once all these procedures heal, there is absolutely no reason why you couldn't do various activities. I think my bunion correction is the one that limits me the most because it left me with a plate and 5 screws. They could all be removed at this point if they were bothersome.
 
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