What is Adult Acquired Flatfoot?

Adult Acquired Flatfoot Definition

Adult Acquired Flatfoot Deformity is a common foot and ankle condition involving the medial column, or arch, of the foot. It typically involves the very important posterior tibial tendon which runs along the medial or inside aspect of the ankle. Whether from chronic repetitive microtrauma resulting in a tendinitis or a more significant injury, dysfunction of this tendon results in less support across the arch and may lead to injury of other supporting ligaments. As the condition progresses, the arch will "flatten".

Adult Acquired Flatfoot Symptoms and Anatomy

The most common symptoms of a fallen arch are pain and sometimes swelling along the posterior tibial tendon on the inside part of the ankle. Other more chronic symptoms can include stiffness and/or arthritis of the involved foot joints. Painful callouses can form as well. This flatfoot structure can even lead to altered forces across the knee joint, sometimes resulting in knee pain or arthritis.

Adult acquired flatfoot shares some characteristics with other arch-related conditions. Posterior tibial tendon dysfunction (PTTD) is closely related, as it involves the same tendon that supports the arch. An accessory navicular bone can also contribute to flatfoot by weakening the tendon's attachment. Cavus foot is the opposite condition, involving an abnormally high arch.

Adult Acquired Flatfoot Treatment Options

Resurgens Orthopaedics offers a range of non-surgical treatment options for adult acquired flatfoot, including:

• Anti-inflammatory medications, oral and/or topical
• Arch supporting shoe inserts, off-the-shelf or custom-molded
• Ankle bracing, off-the-shelf or custom-molded
• Physical therapy
• Weight loss

Adult Acquired Flatfoot Surgery

When conservative treatments fail, surgery may be considered to help reconstruct the anatomy of the foot. Surgical techniques and approaches will vary, but can include the cutting and moving of involved bones, transfers of tendons, and sometimes fusion of affected joints. Surgical options may include gastrocnemius recession, Cotton osteotomy (medial cuneiform opening), lateral column lengthening (Evans osteotomy) or a subtalar implant.

Each surgical option is dependent on the severity of the deformity and other considerations specific to individual patients. These surgeries will include a time period of immobilization and weight bearing restrictions. All of these details will be discussed with your orthopedic foot and ankle surgeon.

Schedule an appointment with a Resurgens physician today or call us at (404) 847-9999.