Patients suffering from back pain, hip pain, knee pain, ankle pain and pain across the medial arch may benefit from a simple surgical procedure called a Subtalar Joint Arthroeresis.  Children and adults suffering from pain and fatigue in the medial ankle and the arches who find themselves easily fatigued during longer periods of walking or difficulty with athletics may be suffering from Posterior Tibial Tendon Dysfunction as a result of a hypermobile and subluxing Subtalar Joint.

 

People who have this problem for prolonged periods of time and do not correct the problem with either Orthotics (arch supports) or a Subtalar implant, as mentioned above, are likely to develop a myriad of painful deformities and foot and ankle problems as they get older.  Among these are Posterior Tibial Tendonitis or Tendon Tendonosis (Tearing and degeneration of the tendon),  Hamemrtoes, Bunions, Subtalar Joint Arthritis, and arthritis of the first metatarsophalangeal joint (The Big Toe Joint).

 

Conservatively, Orthotics will help, but only while wearing shoes.  For proper function and control of an orthotic, the shoes must be well built for motion control, and must be a closed type of shoe.  These devices  will not help function while barefoot or in sandals, or while in unsupportive shoes such as Vans and Converse.

 

A possible surgical alternative is an MBA type of implant which fits between the Talus and Calcaneus (within the Subtalar Joint) to more permanently correct the problem.  This is called and Arthroeresis.  Surgical implantation of this device is relatively simple and involves no cutting of bone, as it fits into a naturally occurring space called the Sinus Tarsi.  Recovery time from such a procedure only requires 2-3 weeks for recovery, as opposed to a 3-4 month recovery, as is needed for a more progressive problem that may result if the problem goes untreated.

 

For more information on the life-time progression of Subtalar dysfunction and Posterior Tibial Tendon Dysfuntion related to this problem, please google ‘Wheeless Textbook of Orhtopedics’ and look up ‘Posterior Tibial Tendon Dysfuction.’  There you will see the arthritic and tendon problems that occur later in life from these problems, as well as the complicated surgeries and recoveries involved in these surgeries.  Adjunctive procedures may be required, such as Achilles Tendon lengthening or Gastrocnemius recession if there is not enough motion at the ankle joint to accommodate the implant.