Foot & ankle · Arch care

Accessory navicular resection in Canada

Accessory navicular resection — also known as the Kidner procedure — addresses chronic medial arch pain and posterior tibial tendon irritation caused by a symptomatic accessory navicular bone, removing the extra ossicle and reattaching the tendon. Consultations with our fellowship-trained foot and ankle surgeons in 1–3 days, with surgery typically 2–4 weeks later. Boot or cast immobilization is typical for the first 4–6 weeks, with most patients returning to full activity over 3–4 months.

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Removes the painful extra bone
Tendon reattached to support the arch
Surgery in 2–4 weeks
No referral required

Physiotherapist guiding a patient through a lunge exercise

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Kidner procedure

The condition

What is accessory navicular syndrome?

An accessory navicular is an extra bone or piece of cartilage located on the inner side of your foot, just above the arch. This extra bone is present at birth but often doesn’t become painful until adolescence or later in life, often triggered by overuse, trauma, or irritation from footwear.

The Kidner procedure is the standard surgical treatment for this condition. It involves excising the accessory bone and reconstructing the attachment of the posterior tibial tendon — the main tendon that supports your arch.

Symptoms & indications

Visible bump on the inner foot
Redness and swelling in the arch
Pain during activity or exercise
Difficulty wearing certain shoes

When non-surgical treatments like orthotics and physical therapy fail to provide relief, surgical resection offers a long-term approach aimed at addressing the source of irritation.

The surgical approach

The Kidner procedure.

A specialized technique designed to restore arch stability and address bone-on-bone irritation.

1

Excision

The accessory navicular bone is carefully separated and removed.
2

Tendon preparation

The posterior tibial tendon is assessed and prepared for reattachment.
3

Reattachment

The tendon is secured back to the main navicular bone using advanced anchors.
4

Arch support

Proper tensioning helps provide long-term stability to the medial arch.

Your surgeon

Our Kidner procedure specialist.

Fellowship-trained surgeon expert in complex foot reconstruction and the Kidner procedure.

Dr. Danny Arora

Minimally invasive foot & ankle surgery · Duke University fellowship trained

Dr. Arora is Duke University fellowship trained in minimally invasive foot & ankle surgery, with expertise in complex foot reconstruction including resection of the accessory navicular and posterior tibial tendon reattachment.

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FAQ

Frequently asked questions.

An accessory navicular is an extra bone or piece of cartilage located on the inner side of the foot, just above the arch. While many people have it without issues, it can cause persistent pain, especially in active individuals or those with flat feet.

The Kidner procedure is the surgical treatment for a painful accessory navicular. It involves removing the extra bone and reattaching the posterior tibial tendon—which normally attaches to the navicular—to the remaining bone to help restore arch support.

Recovery typically involves a period of non-weight bearing in a cast or boot for 4-6 weeks to allow the tendon to heal to the bone. This is followed by a transition into walking in a boot and physical therapy. Most patients return to full activity in 3-4 months.

The Kidner procedure is designed to remove the source of pain and secure the tendon, but it is not primarily a flat foot reconstruction. However, by properly tensioning the posterior tibial tendon, it can help stabilize the arch.

Most patients can return to impact sports like running or soccer around 4-6 months after surgery, depending on the strength of the tendon repair and individual progress in rehabilitation.

No referral is required. You can book a consultation directly with our surgical team to discuss your arch pain and determine if you are a candidate for resection.