What is the Kidner Procedure?
The Kidner Procedure is a specialized surgical operation primarily performed to address issues related to an accessory navicular bone in the foot. This procedure specifically involves separating the accessory navicular from the posterior tibial tendon, a crucial step in alleviating discomfort and improving foot function.
Understanding the Accessory Navicular Bone
The accessory navicular is an extra bone or piece of cartilage located on the inner side of the foot, just above the arch. It is a congenital anomaly, meaning it is present from birth. While often asymptomatic, in some individuals, it can cause pain, swelling, and tenderness, particularly during physical activity or when wearing certain types of shoes. This symptomatic condition is commonly referred to as accessory navicular syndrome.
Why is the Kidner Procedure Performed?
The Kidner Procedure is typically recommended when conservative treatments, such as rest, ice, physical therapy, orthotics, or anti-inflammatory medications, fail to relieve the persistent symptoms associated with accessory navicular syndrome. The accessory navicular can often interfere with the proper function of the posterior tibial tendon, which attaches to the main navicular bone and is vital for supporting the arch of the foot.
Key reasons for performing the procedure include:
- Persistent Pain: Chronic pain and tenderness along the inner arch of the foot, especially during or after activity.
- Swelling and Inflammation: Noticeable swelling or inflammation around the prominent accessory bone.
- Difficulty with Footwear: A noticeable bump that makes wearing shoes uncomfortable or painful.
- Impaired Function: Pain that limits participation in sports or daily activities.
The Surgical Process
The core of the Kidner Procedure focuses on addressing both the symptomatic accessory bone and the affected tendon. The main steps typically involve:
- Excision of the Accessory Navicular: The surgeon carefully removes the extra bone or cartilage that is causing the symptoms.
- Posterior Tibial Tendon Reattachment/Advancement: The posterior tibial tendon, which often attaches to the accessory navicular, is then dissected from the accessory bone. It is subsequently reattached to the main navicular bone in a more anatomical and functional position. This step is critical for not only alleviating pain but also for restoring proper arch support and improving overall foot mechanics.
Benefits and Recovery
Patients undergoing the Kidner Procedure often experience significant relief from pain and improved foot function, allowing them to return to daily activities and sports with greater comfort. Recovery typically involves a period of non-weight-bearing immobilization, often in a cast or boot, followed by progressive weight-bearing and a comprehensive physical therapy program to regain strength, flexibility, and mobility. For more insights into surgical solutions for foot pain, you can learn more about lasting foot pain relief.
