Surgery to Strength: A Literature Review of Postoperative Rehabilitation for Hindfoot Surgeries

Calcaneal osteotomy, subtalar fusion, and triple fusion are the main surgical interventions used to correct foot deformities, reduce pain, and restore functionality in arthritis, flatfoot deformity, and post-traumatic complications. The outcomes of these surgical interventions are dependent on careful surgical planning, postoperative patient compliance, and comprehensive multidisciplinary management. Rehabilitation generally follows a stepwise approach, starting with non-weight-bearing and partial weight-bearing and ending with targeted physiotherapy. This will enhance mobility and strength and minimize complications such as muscle atrophy and joint stiffness. Patient compliance is critical to achieve adequate results as it greatly influences bone healing and leads to better functional recovery. Patient demographics and comorbidities and specific surgical techniques often influence rehabilitation approaches and need individualized tailored treatment plans. This review presents updated evidence and recommends a standard postoperative rehabilitation protocol for these three surgical techniques. Additionally, it will discuss the variations between different protocols in clinical practice, highlight the causes of those differences, and propose recommendations for future research. Recently, it has become increasingly clear that there is a lack of consistent, high-quality evidence to guide postoperative rehabilitation after hindfoot surgery. This highlights the growing need for large-scale research to define postoperative protocols, weight-bearing guidelines, and advanced therapeutic modalities. Establishing evidence-based, broadly accepted guidelines could significantly enhance healing outcomes, functional recovery, and patient satisfaction in foot surgery rehabilitation.