Posterior Tibialis Tendon Surgery

What is posterior tibialis tendon surgery?

Posterior tibialis tendon surgery is a way to fix the tendon on the back of your calf that goes down the inside part of your ankle. A surgeon can do a few different types of surgery to fix this tendon.

The posterior tibialis tendon is a strong cord of tissue. It is one of the most important tendons in your leg. It attaches the posterior tibialis muscle on the back of your calf to the bones on the inside of your foot. It helps support your foot and hold up its arch when you are walking.

An injury might tear this tendon or cause it to become inflamed. Your tendon might also tear or become inflamed from overuse. Surgery tries to correct this damage.

During the surgery, you will probably be sedated so that you sleep. The surgeon will make a cut in the back of your lower calf. Then he or she will either remove or fix the damaged portion of your tendon. If there is damage to a lot of your tendon, the doctor might replace part or all of it with a tendon taken from another place in your foot. He or she may use other methods to repair your tendon as well.

In some cases, a surgeon may do the surgery as a minimally invasive procedure. This means he or she will make several small incisions instead of one large one. Then the doctor will use a tiny camera and small tools to do the repair.

Why might I need posterior tibialis tendon surgery?

If you recently tore your posterior tibialis tendon, you might need this surgery. A tear can happen during a fall. It can also happen if you recently fractured your ankle or dislocated it. Surgery may also be done for chronic inflammation from overuse. You may also have problems with the tendon if you have diabetes or high blood pressure, or are obese or an older woman.

If your tendon becomes inflamed or torn, the arch of your foot may start to slowly fall. This can cause pain and swelling in your foot and ankle.

Your doctor may try other treatments first. These can include things like resting your foot, using ice, pain medications, a brace, steroid injections, or physical therapy. If you still have symptoms after several months, your doctor might advise surgery. Your doctor might be more likely to advise surgery right away if you hurt your posterior tibialis tendon very badly or if the injury happened suddenly.

Depending on your problem, one or more types of surgery might work for you. Talk with your doctor about the risks and benefits of all your options.

What are the risks of posterior tibialis tendon surgery?

Every surgery has risks. Risks for this surgery include:

  • Excess bleeding
  • Nerve damage
  • Infection
  • Blood clot
  • Weakness of your calf muscles
  • Complications from anesthesia
  • Continued pain in your foot and ankle

Your risk of complications may vary by your age, the anatomy of your foot, your general health, and the type of surgery done. Talk with your doctor about any concerns you might have. You can discuss the risks that most apply to you.

How do I get ready for posterior tibialis tendon surgery?

Talk with your doctor about how best to prepare for your surgery. Ask whether you should stop taking any medications, such as blood thinners. If you smoke, try to stop smoking before your procedure. Do not eat or drink after midnight the night before your procedure. Tell your doctor about all the medications you take, including over-the-counter drugs like aspirin. Also, tell your doctor about changes in your overall health, such as a recent fever.

Before your procedure, you may need imaging tests such as an X-ray or MRI.

You may need to plan changes to your home or activities. This is because you won’t be able to walk on your foot normally for a while. Plan to have someone available who can drive you home from the hospital.

What happens during posterior tibialis tendon surgery?

Doctors use a variety of methods for posterior tibialis tendon surgery. Ask your doctor about the details of your surgery. An orthopedic surgeon and a team of specialized healthcare providers will do your surgery. The procedure may take 2 or more hours. In general, you can expect the following:

  • You may have spinal anesthesia, so you won’t feel anything from your waist down. You will also be sedated so you’ll sleep through the procedure and won’t remember it afterwards.
  • A healthcare provider will carefully watch your vital signs, such as your heart rate and blood pressure.
  • Your surgeon will make an incision through the skin and muscle of your lower calf.
  • If you are having a minimally invasive procedure, your doctor will make a small incision. He or she will then use small tools and a tiny camera to perform your surgery.
  • Your surgeon will make an incision through the sheath that surrounds the tendon. He or she will then remove or repair parts of your damaged tendon.
  • In some cases, your doctor may remove another tendon from your foot. This is then used to replace part or all of your posterior tibialis tendon.
  • The layers of skin and muscle around your calf are stitched closed.

What happens after posterior tibialis tendon surgery?

A healthcare provider will watch you for a few hours after your operation. When you wake up, your ankle will be immobilized in a splint. Often, posterior tibialis tendon surgery is an outpatient procedure. This means you can go home the same day. Follow all of your doctor’s instructions about pain medications and wound care.

You will have some pain after your operation, especially for the first few days. Medications can help lessen your pain. Keeping your leg elevated after the procedure may help reduce swelling and pain as well. You’ll need to use crutches and keep your weight off your leg for several weeks. Make sure to tell your doctor right away if you have a high fever or if the pain from your ankle or calf is getting worse.

About 10 days or so after your operation, you will probably have your stitches removed. Your doctor might replace your splint with a cast at this time. If so, follow all instructions about keeping your cast dry. In other cases, your doctor may give you a special removable boot instead of a cast.

Your doctor will give you instructions about when you can put weight on your leg and how to strengthen your ankle and leg muscles as you recover. You may need to do physical therapy as well. You may have pain for months before you start to notice major benefits from your surgery. Follow all of your doctor’s instructions about post-surgery exercises. This will help ensure your surgery is a success for you.

Next steps

Before you agree to the test or the procedure make sure you know:

  • The name of the test or procedure
  • The reason you are having the test or procedure
  • The risks and benefits of the test or procedure
  • When and where you are to have the test or procedure and who will do it
  • When and how will you get the results
  • How much will you have to pay for the test or procedure