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Questions about surgery on accessory navicular bone

Discussion in 'Ask your questions here' started by Dillon, Dec 18, 2009.

  1. Dillon

    Dillon New Member

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    Sorry for this very overwhelming post. I just want to provide as much information as possible.

    About myself:
    > 20 yr old male
    > Active athlete
    > BMI: ~20
    > Non-smoker, non-drinker
    > Currently a Junior in college

    My feet:
    > Flexible flat feet
    > When I'm standing or putting pressure on my foot, my foot is flat.
    > When my foot is relaxed and is bearing no weight, like if I'm crossing my legs and have my foot dangling in the air, then there is an arch.
    > Every time I take a step with either of my feet, my foot flattens its arch when I put it down. When I put pressure on the balls of my feet to step off of it, the mechanics of my foot pull my foot into an arch before completely lifting my foot off the ground.
    > Since a major muscle for this extremely repetitive motion inserts into my navicular, and I have an accessory navicular in my left foot, I've been having soreness for a while now.

    My foot injury past:
    > 1st foot injury was a stress fracture on the 3rd or 4th metatarsal on left foot, caused by running. Treated with 2 months walking boot.
    > 2nd foot injury was plantar fasciitus on right foot, caused also by running. Treated with 2 months walking boot.
    > Sprained left ankle early January 2009, playing tackle football. Hyperdorsiflexion. Yes, it was a stupid idea. Treated with 2-3 weeks crutches, returned to normal activity within 5 weeks.
    > Re-sprained the same ankle early June 2009, playing basketball. Crutches for only two days, returned to full activity within 3 weeks.
    > To this day, I still have minor swelling and some strength inadequacies, but they do not bother me.
    > Current injury is accessory navicular bone in left ankle. Not completely sure what made me first realize it, but I first went to a foot doctor about this issue in beginning of summer 2008. I was fitted with a pair of inserted insoles with arches for my feet.
    > The only thing bothering my feet now is the navicular bone. My previous history of sprained ankles is not bothering me at all. Stress fracture and plantar fasciitis are complete non-issues.

    My past attempts at recovery for accessory navicular bone:
    > Insoles do not really seem to help very much. I've been told recently that my insoles were produced by a bad manufacturer which did not make the arch nearly as high as it should be. I still use them only because they still support my heel and knee.
    > I've been told to use a walking boot for two months to treat this problem as well. However, that did absolutely nothing. It was a complete waste of time.

    My current situation:
    > Contemplating surgery to remove the entire accessory navicular bone. I spoke to another doctor just today, and he said that the surgery might be only and hour and a half. Crutches for 6 weeks, walking boot for 4 weeks. I've been through rehab enough times to know what to do by myself... which is kind of unfortunate.
    > I'm worried about the success rate for this kind of procedure to remove accessory navicular bones. I did a google search and found out on this forum that a lot of people had problems with recovery. I thought this was a very simple procedure, so seeing so many people with problems is making me nervous.
    > I can still function normally, but the pain can sometimes give my walk a limp. It prevents me from running on treadmills.
    > I want the surgery because I feel like 6-10 weeks of no activity is better than being haunted by this thing for the rest of my life. Two years of insoles and other failed attempts have done NOTHING to make it any better. I figure that it's best to remove it now, while I'm still young and my body can still allow fast and effective recovery.

    So I guess I'm just wondering whether or not other people who have experience with this situation can comment. What is the success rate for this surgery? Are there any side effects of which I should be aware? Does this recovery timeline sound correct to you?

    I'm pretty nervous about this, but I feel like surgery is the best option. If you have anything meaningful to say, I would greatly, greatly appreciate it!
  2. FootDoc

    FootDoc New Member

    Success rates for most routine surgeries are meaningful only as they pertaining to the individual surgeon performing the procedure. Ask your doctor how many such procedures he/she has performed, what percentage were successful IN THE OPINION OF THE PATIENT, what were the complications and how often did they occur. Also, you should have performed due diligence in checking out the competency of your doctor.
    Last edited: Dec 19, 2009
  3. Unregistered

    Unregistered Guest

    I had my accessory navicular removed right before christmas this past year. I only had it in my right foot. I am 26. My doctor said he typically removes them from 13-16 year old girls. He also told me that the MRI showed that the extra bone was destroying my tendon and if I waited much longer I would have to have tendon replacement surgery. Mine was about the size of a quarter. My doctor said it was the largest he has ever seen. I spent 6 weeks in a cast and on crutches. Spent 3 weeks in a walking boot. I had 7 weeks of physical therapy. I see that you said you have Physical therapy enough to know what to do, but you really need to see a therapist. It is a very hard surgery and a very hard recovery. I am going to be honest and tell you it is VERY painful. My surgery was over three months ago. I still have problems standing or walking very far. I am slowly getting back into the gym. My doctor told me it would take another three months before I would be at 100%. So just know the process isn't fast. But I feel 6 months of recovery is better than a lifetime of pain or a more complicated surgery down the road. I hope this helps you.
  4. Henryka

    Henryka Guest

    Hey there,
    thank you - Dillon, in "my current situation", you are describing exactly how I feel.
    Thank you both for your info; i now read closely the whole forum, oh my goodness - it is a pity that the surgery is that complicated.
    I am afraid the tendon or anything will be dammaged if i do not get it operated; unnecessary to say that i am having pain every day being 20 years old. Oh no ;) What to think? 'Cause the descriptions of hard recovery are like what my surgeron honestly said: at first try all which is not operative.
    Thanks and I hope it goes on well with you,

  5. Unregistered

    Unregistered Guest

    On Sept 9, I underwent surgery to remove my accessory navicular bone and to loosen my calf muscle (incredibly tight from years of over-correcting). I am 41 y/o, male, 6' 1", 190 lbs. (at least at the time of surgery - lol) and a regular runner who does two to three 1/2-marathons a year, numerous smaller races, and other cross-training activities.

    Last summer while training for a half, I was at the tail-end of an 11-mile run when I caught the edge of a small sand hole on the trail and sprained my left ankle. After it healed, I noticed sharp pain developing in my in-step while running. I took some time off and did the P90X series to maintain my shape. As soon as I started running, the pain returned. A trip to the sports orthopedist and an MRI identified the accessory navicular bone. Surgery was listed as a last resort and we tried rest, inserts, and physical therapy - none of which relieved the issue. I checked my doctors credentials, got a second opinion, and finally committed to the surgery.

    I am 2-months into my recovery and still on crutches. Friday I find out if I can begin walking again without the crutches and get a schedule on when I can begin physical therapy. Like previously mentioned, this is a painful operation/recovery. I have only had one operation prior (septoplasty) and while painful, it only lasted a couple of weeks. The pain from this operation lasted approximately 5-weeks. Vicodin took the edge off but left me in a haze for weeks because it screws up your sleep quality. Today, there is no pain but I can feel a tightness in the bottom of my foot.

    I was back at work 4-days after the surgery; however, the bank for which I work has a virtual work from home program so I was able to work from my bed - both a blessing and a curse. :) The great thing is that I was able to keep the foot elevated all of the time. For the person with a desk job, you will find that swelling and pain will occur while in a sitting position, even with a minimal amount of weight placed on it. Try to keep it elevated as much as possible.

    Hopefully I will start into physical therapy soon. I expect it to be a lengthy process but I am anxious to get back into some activity. Good luck with your surgery. I hope that you have a speedy recovery!

  6. Jeaneen

    Jeaneen Guest

    I had my accessory navicular removed 10 weeks ago and I feel great. I had no pain after surgery. I was non weight bearing for 2 weeks, then a walking cast for 3 more weeks. The surgery was definitely worth it! I have some post op soreness, which I anticipate will be gone in the next few weeks. But the actual pain from the extra bone is definitely gone. So nice to be active again!!!
  7. Unregistered

    Unregistered Guest

    I am 17 and have accessory navicular bones in both of my feet and they have always bothered me from when i was a gymnast and when i go running but have gone down over the years. 3 months ago i rolled my ankle and my accessory navicular bone on my right foot has been enlarged and very painful, i can no longer run and i am very active. i dont know whether to have surgery on it or try a boot to stay off of it? any suggestions?
  8. Hi,

    I had my AN on my left foot removed on 17th February 2010. It had worn open my tendon sheath and caused burning and discomfort. The swelling when flying on planes was alarming!

    I was on my back with my leg elevated for EIGHT WEEKS after surgery, as the swelling risked the tendon hook popping out of the bone. It was a painful recovery, added to by the fact I am allergic to most strong pain relievers. (Frustrating!) I was walking with a limp from 8-16 week post surgery, with a lot of muscle wasteage, and running on soft surfaces after six months. I had no physio therapy at all since the operation, but the joint is now strong.

    It is now 12 months since, and I still have pain when I crouch down, and when I walk in bare feet for long periods on hard surfaces. It was worth it but sadly the skin is so thin on the area, that I can't play Soccer.

    My other foot may need this done in the future, and all I can say is I will prepare for it six month in advance.

  9. Hello,
    I definitely dont know what the one person is talking about they were walkibg after 3 weeks....i am 32 and my AN removal was last Friday, 6 days ago ... My only advice, rent a hospital bed......after being ib bed with leg and foot elevated, i have severe pain...like, i have had 3 C-Sections and i wasnt in near as much pain as my 1st 72hours. Please, please have some help, 24/7, no matter how active you are. Literally you only have one working leg/foot to use. Try not to move around alot this 1st week. I pay for it later. Good luck!!!!
  10. Unregistered

    Unregistered Guest


    my son has AN bone on his left foot. He is 13 and the doctor suggested first an ortho cast and some physioyherapy for the beginning. He walks with a limp and it hurts.. :( I read about surgery and it does sounds very scary... He is a competitive swimer and he needs to exercise..he also likes to run around and play soccer.. Is it really surgery a bad idea?
  11. Unregistered

    Unregistered Guest

    I am having my AN removed from my left foot next week. I'm 6'5", 180lbs, 22 years old and very active. I dont want to have to deal with the discomfort from it so I'm getting the procedure.

    I have had the AN my whole life, but it didnt bother me until I irritated it with a football injury (bad sprain on the inside of my L ankle). Whenever I am active, whether it's walking around downtown or cutting left and right on the soccer field, it bothers me.

    The Dr. removing the bone has been doing these procedures for just under 10 years and came recommended by the Dr. who replaced my fathers hip.

    My advice: get it taken care of, but make sure the Dr. is one of the top orthopedic surgeons available before deciding to have the procedure.
  12. Unregistered

    Unregistered Guest

    I'm about to have my AN removed from my right foot after an injury causing more pain than normal and is not healing. I had this injury to my left foot 10 years ago when I was 17, two months of rest and walking boot, it wouldn't heal and I had surgery to remove it. It was a 3 week recovery. Now I'm reading about these long recoveries and am worried this surgery might not go as well. My bone is a half moon shape about the size of a half dollar. Normal AN bones are pea sized. I wonder is this different size and shape of the bone affects tendon connectivity and the surgery and recovery? I do know that the previous surgery has helped me. My dad has lived with chronic foot pain all his life and it never gets better. I think he would have been much happier if he had the surgery.
  13. Unregistered

    Unregistered Guest

    I had the surgery to have the accessory navicular removed on July 5 this year. I was in a giant dressing for 1 week, a hard cast for 2 weeks, and a walking boot for 3 weeks. I didn't actually have any pain until I got the hard cast. Then it started getting achy and painful. This week I started wearing a shoe on that foot again and walking around normally. It gets achy in the evenings (from walking around durning the day I assume) and sometimes I get a shooting pain that goes away right away, but other than that i had almost no pain. I am also allergic to oain killers, so i was very worried, but the whole process was much better than i expected. I was supposed to start physical therapy this week, but I didn't want to miss more work so I'm putting it off. Does anyone know what kinds of things they do in therapy?
  14. Unregistered

    Unregistered Guest

    Hi Travis,

    I am actually going in for my surgery tomorrow morning! I was in a boot for two months and in physical therapy. It took the edge off my pain so I could walk without limping, but I wasn't pain free while walking and it goes without saying that I couldn't get to my previous level of activity. (5-6 days/week of tennis)

    While in my boot, it started a number of conversations with people who had the same problem. They ALL said they tried non-surgical interventions first (from 1.5 to 12 years) and ultimately ended up having the surgery. NO ONE said immobilization worked and healed it. Long story short, all of them said they are now pain free and wished they had just gotten the surgery from the outset and they actually encouraged me to go ahead and get the surgery. Learning from what these people have told me, I decided to go ahead with the surgery. I need to get on with my life!! My doctor has said I will be in a cast for 6 weeks and then a walking boot for another 6. I can return to tennis six months after the surgery.

    I think you are right, you are young and your body will probably knit back together a lot faster than mine will! (I'm 43. Ack!) You might want to give yourself a certain amount of time that you are willing to spend on non-surgical intervention (a deadline, if you will) and then think about pulling the trigger if it's not better by then.

    Good luck to you Travis!
  15. Unregistered

    Unregistered Guest

    Im a 34 yr old female, average height / weight, I had my surgery on October 23rd, about 6 weeks ago. Getting the bone removed wasn't the problem for me, it was the tendon they have to cut to get to it that prolonged my recovery. They cut the tendon, remove the accessory navicular, then have to reattach the tendon to the navicular bone. I'm guessing that might be the difference between people having an easy or long recovery. I had a very big accessory!

    Initial I was told splint non wearing for 2 weeks, cast non weight bearing for 4 weeks, then walking boot (cam boot) for 6 weeks. When I had my splint & stitches removed ( 7 stitches) I was healing well enough to move on to cast in a walking boot for 3 weeks without crutches. Got cast off yesterday, still swollen, sore & stiff, but slowly feeling a bit better. Happy to be in shoes again!

    As for pain, I was taking pain meds religiously every 4 hours. For the first week it throbbed, you could literally feel it swelling when upright. For myself, elevating was the only thing that really helped. The higher my foot, the better it felt.
  16. Unregistered

    Unregistered Guest

    im a 15 year old girl and ive had "arch pain" my whole life. i guess ive been seeing bad doctors because just this week i went in and they said i had AN in both my feet, as well as a stress fracture to my navicular. the doctor thinks i need surgery to remove the bone because ive already had a green break to my navicular and i shattered the growth plate there. i also have abnormally high arches. the pain has stopped me from running and dancing for the past 2 years. it doesn't matter what i do i cant make it bearable. i think the surgery will be worth it if it takes all this pain away.
  17. Unregistered

    Unregistered Guest

    I'm 35 and had an AN in both feet. I first started to have trouble with my right foot when I was 11, after I turned my right ankle. My mom took me to several doctors before we were referred to someone who could diagnose and treat what was wrong with my foot. I don't know the procedure he did, but I stayed one night in the hospital, probably because I was 12, and was on crutches for six weeks. I didn't have a walking cast, and boots weren't around yet. The pain never really got better, and at 16 I was unable to participate in sports, other than swimming, because of the pain.

    At 19 I had the Kidner procedure done on my right foot because I had a bone spur on my navicular bone. After the surgery the doctor told me that the tendon on my right foot had been as hard as bone. I was in college then, had an outpatient surgery, and spent six weeks in a boot and on crutches but didn't have any PT. I had the surgery done over break and had two weeks to recover, then went back to class. Yes it was hard, and yes it hurt. When I was finally able to walk on it it hurt worse than it did before. I'd had a slight limp before the surgery, but now I strongly favored my left foot, even given scheduled, prescription strength anti-inflammatory pain medication. It wasn't long before I started to have a lot of pain in my left arch and had to have outpatient surgery on that foot too. The same doctor did the Kidner procedure on my left foot a year and a half later, and told me the tendon in my left foot had been harder than the tendon in my right foot had been. I was in a boot and on crutches for six weeks with no PT on this one, too.

    I would like to say all of this has had a happy ending, but it hasn't. I'm NOT writing this as an attempt to discourage anyone from having this surgery, but more as a cautionary tale. If I'd had treatment earlier my tendons would not have been so badly damaged, and I may have had a better prognosis. As it is, the damage to my tendons may have caused my ankle joints to become unstable, and as a result I have arthritis in each. My problems may or may not have also had something to do with the doctor who did the surgery. I was 19 and 20 when I had my surgeries, and did not have the wisdom to check out the doctor who did the surgeries. He was the doctor my mom took me to, and I trusted her decision.

    So the moral of the story is, if you have ANs, don't wait too long to get surgery. I was told by my original doctor that ANs come in three sizes: too small to surgically treat, medium sized ones that can be surgically removed if they cause pain/problems, and those that are so large they must be surgically treated. If you have an AN, or ANs, that haven't responded to stabilization, it isn't going to get better but things may get a lot worse. Next: Do your due diligence on your doctor. Any doctor can make a mistake or perform poorly on one surgery, and there are no guarantees in surgery so there's always a risk, but try to make sure your doctor doesn't do it routinely. Finally: Follow your doctor's orders! Use your crutches and don't walk on it early, wear the boot, get the PT, do the PT.

    Finally, on my experience with the pain. I don't remember the pain being as intense as some people report, but everyone has a different tolerance for pain, and you probably know your own personal tolerance best. By the time I was 12 I'd already had surgery once, and by 19 I had been living with chronic foot pain since age 11, and had three surgeries, the last one being the most painful experience I'd had to date. My experience was therefore colored by the fact that I had already been exposed to a lot of pain and the pain from my foot surgery paled in comparison to the surgery I had just before this one. It was actually a lot less painful than I expected. However, if you have never had any kind of surgery or serious injury this will probably be more painful than anything else you have experienced to date. No matter your history and/or pain tolerance though, don't expect, as a certain relative of mine did, to repaint your house for your son's graduation while you are trying to recover from surgery. It's not going to happen. ;)
  18. Unregistered

    Unregistered Guest

    My daughter is 12 and she has an accessory navicular. 1 yr ago was when we found it when it flared up and she was in a cast for 4 weeks and a boot for 3 and PT for 6 weeks. It never got 100% better but she was able to live an active life style. She also had custom orthopedics made.
    Recently it flared up again and she can barely even walk. It has been like this for about a week. She just recently got her orthotics altered but no improvement has been seen.
    I don't think that having bad flare ups and not being able to enjoy exercise is any way for a 12 yr old to live. I was wondering if surgery is the best option or if there is anything else. Also what are the risks of surgery.
  19. bonespurs

    bonespurs New Member

    Because of your daughter's accessory navicular bone it may be necessary to perform surgery. I'm not a fan of surgery nor do I condone it, however, I think one thing we should consider is "WHERE" exactly she's feeling the pain. Because if she's having pain in the arch of her foot or her heel, than it may be a flare up of Plantar Fasciitis, and not the actual accessory itself. If it does happen to be Plantar Fasciitis then I definitely do not suggest surgery since 30%-60% of patients have reported the return of pain. That's not a very good statistic if you ask me.

    First try an Ice Pack to bring down the inflammation. This will give you the opportunity to look into the foot a bit better and locate the source of the pain. She shouldn't be suffering pain at such a young age, but bear in mind that having an accessory navicular bone does affect 2.5% of the population. So it isn't really common.

    Once you locate the source of the pain, you'll be able to take appropriate action.
  20. Unregistered

    Unregistered Guest

    We have confirmed that it is an accessory navicular and we were wondering if you can grow out of it or if it can fuse and how often if at all does that happen? Thanks so much for your answer!

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