Many Americans suffer from various forms of flatfoot, a physical condition where there is an absence of the arch that runs from the toes to the heel of the foot. In some instances flatfoot arises from abnormal foot development. Children with flat feet should be treated early to prevent progression of the deformity. In some cases, typically in adults, flat feet may be caused from a tendon rupture, foot and ankle trauma or arthritis. Without treatment, consequences can be severe.


The most common symptom of flatfoot is pain. Due to a weak structure, feet that are lacking arches cannot support the weight of the body properly. Years of walking with over-pronated feet can cause structural changes to the ankles as well as the knees, hips and back. In addition, lack of shock-absorption causes an increase in pressure to these joints and may lead to pain, joint stiffness and arthritis.

Symptoms

  • Pain in the arch
  • Inability on toe stand
  • Pain in the outside of the foot
  • Muscle cramps in the calf and ankle
  • Leg and foot fatigue
  • Difficulty in standing and walking
  • Knee discomfort
  • Clumsiness and easy fatigue

Treatment Options
Treatment of flatfoot depends on the severity of the condition. Mild cases can be treated with corrective shoes and orthotics. The additional arch support provided by the use of orthotic devices will not correct the condition but will help to provide support to the foot and control pronation. This conservative treatment method may be all that is needed to prevent the condition from worsening and causing other joint problems.

Severe cases may need to be treated surgically. There are several types of procedures that are being used to correct severe flat feet that typically include adjunctive procedures to reconstruct tendons or ligaments that may be contributing to the condition. Some procedures use implants. Surgeons will carefully consider all options before choosing the option that is most suitable for the patient.

One surgical option that has become the treatment of choice for many surgeons is the MBA implant. The Subtalar MBA implant is small soft-threaded titanium device that is inserted into a small opening called the sinus tarsi. The placement of the implant restores the arch by preventing the displacement of the talus and by preventing the foot from rolling-in (pronating). Tissue grows normally around the implant and aids in holding it in place. It is like an "internal orthotic."

Benefits of the Subtalar MBA

  • Procedure is easily reversible
  • No holes are drilled or bone is removed
  • No bone cement is used
  • Less chance of infection
  • Improved gait and appearance
  • Decrease in pain and tiring of the feet and legs
Procedure
The insertion of the implant involves a brief outpatient surgery, several stitches to close the incision.
What To Expect After Surgery
Following surgery you will typically be in a weight-bearing cast for two weeks followed by two weeks in a protective boot. If adjunctive procedures are performed, the postoperative care may vary.

Some FAQs

Q: Is surgery necessary?
A: In adult patients, after all conservative options have failed, surgery may be the best alternative to correct the deformity and lessen pain.
In children, surgery may be necessary to prevent the progression of the flat fleet and to enable the child to live a more active lifestyle.

Q: Is my child to young for surgery on his/her feet?
A: Correcting flatfeet at an early age may prevent the pain and suffering many people with flatfeet go through from adolescence into adulthood. Surgery at an early age can correct the alignment of the bones in the foot, before the bones mature in an incorrect flatfoot position.

Q: Is an implant necessary?
A: No, an implant is not necessary. Other surgical procedures can be done that fuse bones together using screws or other types of devices. These procedures are much more invasive and are permanent. An implant may provide for faster healing time and pain relief with out altering the bones in your foot.

Q: When is the implant removed?
A: The MBA implant does not need to be removed. The implant is placed in a joint in which there is a natural space. This space will always be there although tissue will develop around the implant to hold it in place.

Q: What other problems do flat feet cause?
A: Strain from flatfeet can lead to many other foot problems. These may include: hammertoes, bunions, heal spurs, corns and calluses, and possible neurological problems. Foot fatigue may begin to affect other parts of the body and cause pain and stiffness in the knees, hips, and lower back.

Q: How long will it take to recover after surgery?
A: If the MBA implant is the only procedure that is performed, the recovery time is very quick. Many physicians have patients walking the same day in a protective boot or cast. After two-four weeks of rest, many patients are back normal activity. If other procedures are done with the implant, recover time may be longer and will vary from patient to patient.

Q: Will I be able to play sports after surgery?
A: Yes, most definitely. Your should see dramatic improvement following the surgery. Many people are more active and participate in sports for longer periods of time after having MBA surgery because they no longer have foot pain and fatigue in their legs.

Disclaimer
Not everyone is a candidate for the Subtalar MBA Implant. Your doctor is the final judge.  

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