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Old 01-22-2011, 07:09 PM   #1
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fallen arch reconstruction surgery

I have a fallen arch and an orthopedist specializing in foot surgery has suggested talonavicular fusion and calcaneous osteotomy. I am agonizing over decision whether to go ahead with it. On the one hand, I have managed to live with the pain for a long time; although it has gradually gotten worse, the pain is not unbearable unless I walk a long distance, and is helped by use of the Arizona Brace. I am however not walking quite as much as I would like. Some say I should not have surgery unless and until the pain is unbearable or is having a dramatic affect on life style. I understand that recovery is very difficult and I worry about something going wrong. On the other hand, the orthopedist, while not urging me to have the surgery, tells me it will continue to get worse and, if I wait, might eventually necessitate triple arthodesis fusion, which I understand is more invasive. Also, at 58, I am not getting any younger, and if I have surgery later, recovery may be more difficult, and i would like to be able to walk substantial distances. Any comments about this procedure, its success or failure, and the recovery/rehab experience would be appreciated.

 
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Old 01-22-2011, 08:31 PM   #2
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Re: fallen arch reconstruction surgery

Several people on this board have had flat foot reconstruction surgery. I was on disability for four months because my job requires me to be prety mobile. I am 5 1/2 months post op posterior tibial tendon and spring ligament repair, calcaneal and cotton osteotomy, tendon transfer and lengthing of the achilese tendon. So far, I am doing very well. Prior to surgery, I was experiencing increasing pain, even wearing my arizona brace. I have been back to work about 7 weeks. The first few weeks, the doctor had me wear the aircast to work and shoes with an aso brace when not at work. For the past four weeks, I have been wearing shoes all the time. For two weeks, I wore the aso brace at work and for the past two weeks, I have worn shoes without the brace For most of the day, I completely forget that I ever had surgery I still get twinges and occasional aches but I am considerably better than prior to surgery. Heeling can take up to a year which means that I have plenty of time to continue to improve. The recovery is definitely long a tough. I was nwb for 8 weeks, followed by several weeks in an aircast. As with any surgery, there are no guarentees; however if your condirion continues to worsen, you may end up with a tripple fusion. If you haven't already, I would strongly reccomend that you go for a second opinion. Also, ask the doctors their post op protocol and how many of these surgeries the do. Flat foot reconstruction is a complex surgery and you definitely do NOT want to use someone who does one or two a year. I went to four different doctors, 2 podiatrists and 2 foot and ankle orthopedists (only do foot and ankle surgery). I started reading peer review articles on flat foot reconstruction and looked at the names of the doctors quoted in articles. The doctor I ended up using works at a top ranked orthopedic hospital and was referred to in about 75% of the articles. I also checked the state medical boards to be sure he had a clean record. A pt that I had used in the past had mentioned that his first job was working for a foot and ankle surgeon. The pt contacted the doctor he knew to find out what he knew about my doctor. The doctor had glowing comments about the surgeon I used. Please be sure to get more than one opinion and then research which doctors specialize in flat foot reconstruction. Choosing wisely can increase your chances of a good outcome. I am 55 so not far behind you. Good luck

Last edited by roxygirl1; 01-22-2011 at 08:39 PM.

 
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Old 01-23-2011, 01:37 AM   #3
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Re: fallen arch reconstruction surgery

I am 5 months post op calcaneal osteotomy, kidner procedure, posterior tibial tendon repair, fdl tendon transfer and achielles tendon lengthening. I agree with Roxygirl to get a 2nd or even a 3rd opinion. Yes, it is true the recovery is a very long one that continues even after you return to work. It takes a year to fully recover. The one thing you have to keep in mind, the longer you do wait to have the surgery, the more damage that can happen inside of your foot. Pre-surgery I was in severe pain. It turns out that at some point after the MRI was done, a bone had fractured off. I am 51 so I do understand how you feel about not getting any younger. I think most doctors prefer to take the conservative approach and do everything to avoid surgery. I started back to work 4 months post op. My job is in a hospital and I am on my feet all day. I do have some aches and some days swelling to contend with. Nothing I feel now compares with the pain I had prior to surgery. For me, surgery has been the best solution to the pain I had before surgery. If I had to do it all over again, the decision would be easy - I definately would.

 
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Old 01-23-2011, 07:07 AM   #4
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Re: fallen arch reconstruction surgery

Thanks so much for your detailed advice. You gave me a number of points to think about. I have gotten two opinions so far. In both cases the docs did not push the surgery, but suggested it as an option. The orthopedist I am inclined to go with for the surgery is very highly rated. My bottom line is if it will inevitably get worse and I will need this or a more extensive surgery at some point (which may be the case, but I am not sure), I would definitely do it now.
If you have any additional comments, that would be great, but in either event, I appreciate your time and thoughtfulness in replying.

 
Old 01-23-2011, 07:32 AM   #5
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Re: fallen arch reconstruction surgery

It is good that neither doctor is pressuring you. I guess that if it were me, I would do the surgery if despiite trying conservative approaches the doctors both felt that your condition would become progressively worse and if you were finding that pain is negatively impacting upon your day to day activities and preventing you from doing what you would normally do. If you do have the surgery, it is important to find out specifically what will be done and the post op protocol. You would also have to make sure that you have someone who can help you until you are more mobile and have all necessary equipment in your home before the surgery. It is a big decision. Would it help you if you went for one more opinion? Several years ago, a knee surgeon told me that he never pushes knee replacements because no matter how good the doctor is, there is always a chance of a less than satisfactory outcome. He wants all of his patients to feel that they had no choice but to have the surgery instead of saying "why did I do it." For me, so far I am thrilled that I did have the surgery. Good luck in your decision and keep us posted

 
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Old 02-14-2011, 08:59 AM   #6
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Re: fallen arch reconstruction surgery

I did have the talonevicular fusion, and related procedures, done last Tuesday. Surgeon told me after the surgery that it went very well. I go back to see him a week from today. As several of you have indicated, and as the surgeon warned, the pain and discomfort after surgery are intense. The first three days I experienced unrelenting pain and pressure, despite being on pain medication. The pain has eased up some since then but continues to make life difficult.

I am curious whether those of you who had this procedure stayed overnight in the hospital and, if so, for how long. The protocol at the hospital where I had this done called for no overnight for this procedure - which I find surprising considering that this is major surgery and pain management post op is critical. (I have alot of confidence in my surgeon, but question this aspect of the protocol.)

Given the surgeon's favorable comments about how it went, I am pretty optimistic about the ultimate result, although I realize that it will take a long time to really know and, as I understand it, fixing the anatomy does not necessarily mean that the symptoms will be eliminated or mitigated. In any event, at least at this point, I feel I made a good decision in having the surgery.

Any comments you may have at this point would be appreciated, and I would also be interested in knowing whether there are any updates on how those who commented before are faring with their recoveries.

Now that I have had the procedure and have managed through the first week of post-op, I would be glad to answer questions that might be helpful to those who are scheduled for, or who are thinking about having, this surgery.

Many thanks.


Quote:
Originally Posted by roxygirl1 View Post
It is good that neither doctor is pressuring you. I guess that if it were me, I would do the surgery if despiite trying conservative approaches the doctors both felt that your condition would become progressively worse and if you were finding that pain is negatively impacting upon your day to day activities and preventing you from doing what you would normally do. If you do have the surgery, it is important to find out specifically what will be done and the post op protocol. You would also have to make sure that you have someone who can help you until you are more mobile and have all necessary equipment in your home before the surgery. It is a big decision. Would it help you if you went for one more opinion? Several years ago, a knee surgeon told me that he never pushes knee replacements because no matter how good the doctor is, there is always a chance of a less than satisfactory outcome. He wants all of his patients to feel that they had no choice but to have the surgery instead of saying "why did I do it." For me, so far I am thrilled that I did have the surgery. Good luck in your decision and keep us posted

 
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