Procedure
Accessory Navicular Excision & Tibialis Posterior Advancement
For Accessory Navicular
What It Involves
The operation involves two key steps through a single incision over the inner side of the foot. First, the accessory navicular bone is excised and the bony prominence on the navicular is smoothed flush — removing the bony lump entirely. Second, the tibialis posterior tendon — often partially displaced by the presence of the extra bone — is reattached firmly to the navicular in an optimal position, restoring its mechanical function and supporting the arch.
The procedure is performed under general or regional anaesthesia as a day surgery case and typically takes 45–60 minutes.
Recovery Timeline
Everyone heals at a different rate — this timeline is a guide.
Weeks 1–2
Non-weight-bearing in a cast, with strict elevation. The wound is checked and sutures removed at 2 weeks.
Weeks 2–6
Transition into a boot, remaining non-weight-bearing for a further 4 weeks while the tendon repair consolidates, with continued elevation. Sedentary work is typically possible from this point.
Weeks 6–12
Weight-bearing begins in a CAM boot from around 6 weeks, with a clinical review and physiotherapy for tendon strengthening and arch rehabilitation. Roles requiring prolonged standing or walking need approximately 10–12 weeks off.
3 months
Most daily activities have resumed, transitioning out of the boot into supportive footwear.
3–6 months
An arch-supporting orthotic is recommended to protect the repaired tendon and maintain the corrected arch position, particularly if you have an associated flat foot.
6–12 months
As this is a major reconstruction, full return to sport and higher-demand activity is expected to take 6–12 months, with a final review and discharge once achieved.