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  • Foot surgery for seniors - post tibial tendon dysfunction

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    Old 09-19-2009, 02:42 PM   #1
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    Foot surgery for seniors - post tibial tendon dysfunction

    Has anyone in their 70's had surgery for post tibial tendon dysfunction (PTTD)? I am a healthy 72 but I have mild osteoporosis (T score -2.6) and my planned surgery includes two bone procedures - an Evans calcaneal osteotomy and a talonavicular fusion with metal plate and screws. I'm worried that the screws might not have good enough bone to hold onto. My podiatrist didn't mention bone density when he recommended the surgery. Does anyone have experience with this? Thanks lots for any comments you may have.

    Last edited by Marygetwell; 09-19-2009 at 04:30 PM. Reason: correct a typo and spell out podiatrist rather than DPM

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    Old 09-21-2009, 08:57 PM   #2
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    Re: Foot surgery for seniors - post tibial tendon dysfunction

    I would get a second opinion from a Board Certified Foot and Ankle Orthopaedic surgeon before having the surgery. If he/she concurs with the DPM's surgical plan then you can feel confident in going forward. If there is a difference of opinion you may want to seek a third. I have heard of "older" people having had this surgery and doing well. I kinow there is at least one person who posts on here who is I believe in their late sixties.

    I would also ask your surgeon how often he or she performs these surgeries, how often have they had patients your age undergo the surgery and what the outcomes were for them. I would ask if there are any particular concerns about rehabilitation because of your age. If you are in otherwise good physical health and are active without any other underlying medical conditions that would impede healing, I see no reason why your age would keep you from doing well with the surgery. The alternative isn't very appealing! If you are very active I don't imagine you would want to be hindered by braces, boots, or wheelchairs the rest of your life.

    Best of luck to you. Let us know how things turn out.


    Old 09-21-2009, 09:03 PM   #3
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    Re: Foot surgery for seniors - post tibial tendon dysfunction

    I am 65 years old and had PTTD surgery in April. My surgery included tendon transfer and calcaneal osteotomy (no need to get bone graft from my hip). I have 2 screws from the root of my big toe to the next bone; and 2 screws on my heel. I was on surgical splint for 2 weeks, hard cast for 4 weeks, and air boot for 6 weeks. While in splint and hard cast, I was 100% non weight bearing. I used knee walker and regular walker (go to small area) during this period of time. While I was in air boots for 6 weeks (partial weight bearing), I used crutches to get around. I have been wearing tennis shoes and sandals since the end of June. This period of recovery is still kind of difficult. I experienced pains while walking; swells continue as expected. I was reminded several times by my doctor that full recovery takes 10 months to a year. However, I do have to admit that I have been feeling a lot better lately. My gait is getting to be normal and my pain and swell are reducing. So I am feeling positive that the full recovery will eventually come, just have to be patient.

    My surgery foot (right foot) showed osteopenia after non weight bearing for so long. However, doctor said that once I start using and exercising the leg, I will get better and recover from osteopenia. An OS will be able to give you an answer about bone healing at your situation.

    Personally, I think my recovery is pretty normal, but maybe a little slower than younger folks. Age definitely slows recovery. Other than that I am a pretty healthy person.

    Old 09-22-2009, 05:05 AM   #4
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    Re: Foot surgery for seniors - post tibial tendon dysfunction

    emmie, foothelper, and yaohua Ė what a gift to wake this morning and find your messages! I feel encouraged by your comments that general health and activity level are more important than age alone Ė there I think things are in my favor. Yaohua, I'm glad you are doing well. And it's good to know you've made this progress at age 65. My doctor said I would be nonweight-bearing for 10 weeks then in a walking boot for 2 or 3 weeks and then three months of physical therapy. So far Iíve used orthotics for 10 pain-free years; never had a UCBL; then when the post tibial tendon suddenly became very painful this past May I had a Richie Brace made, but it pressed hard on my navicular area. Three returns to the lab did not fix that, but began to ruin what had been a very comfortable footbed. So Iím not sure if I have really failed the brace or if someone else could make one that would fit well, or if the navicular sticks out too far for the brace to accommodate it and still provide support. Iím scheduled for a second opinion from a foot OS Oct.8. Iíll let you know what happens. Thanks so much again.

    Old 10-14-2009, 01:38 PM   #5
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    Re: Foot surgery for seniors - post tibial tendon dysfunction

    I had a second opinion today. Basically the doctor urged against surgery until I try the Arizona brace. He said the Richie Brace which was painful and not wearable for me is not appropriate for someone at my stage (II) of PTTD. He thinks the Arizona brace will keep my foot from progressing to stage III and that I'll be able to do all the things I like to do and need to do if I wear it. Which I will. I'll let you know how it goes. Thanks so much for your posts!

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