Adult Flat Foot Triple Arthrodesis Patient68 year old caucasion female with posterior tibial tendon dysfunction (PTTD), referred via our website: www.NaplesPodiatrist.com, severe pain 10/10. Surgery in April with 12 wks of non weight bearing, then therapy. 6 months followup with no swelling or pain. Hardly noticable scarring inside or outside. PTTD otherwise known as adult acquired flat foot is a very painful condition characterized with dropping of the arch and pain with every propulsion during the walking cycle. When choosing a surgeon for this procedure, make sure they do enough to be proficient, MD ortho or DPM Reconstructive Ankle surgeon. Patient references are a must. Revisions of this procedure are not fun, unfortunately we have become proficient at that too from other institutions.