A bunion (hallux valgus) is among the most common orthopedic issues affecting the feet. The root cause of a bunion is a structural deformity at the metatarsophalangeal joint (MTP)—the big toe joint.
The bones of the foot move out of proper alignment as the first metatarsal bone shifts toward the inside of the foot and the big toe angles toward the second toe.
When does a bunion require surgery?
As your bunion progresses, it forms a bony bump on the side of the foot. However, it can also cause other complications, such as:
- Bursitis — inflammation and fluid buildup in the bursa sac, which acts as a lubricant between the bones and soft tissue (muscles, ligaments, and tendons).
- Metatarsalgia — ball of the foot pain.
- Hammertoe — a toe deformity. Pressure from a bunion can cause an abnormal bend in the joint of your other toes.
If nonsurgical treatments do not provide symptom relief and movement is restricted, your podiatrists at The Bunion Institute may recommend a bunionectomy — bunion correction surgery. But how successful is bunion surgery really?
What are the different types of bunion surgery?
The effectiveness of your bunionectomy will somewhat depend on which surgical procedure you have. The podiatrists at The Bunion Institute are well-versed in the latest, minimally-invasive bunion correction surgeries (as well as well-educated on which surgeries are no longer useful.)
Traditional bunion surgery
Traditional surgical procedures — metatarsal osteotomy and Lapidus bunionectomy — are more invasive bunion surgeries. Patients will be non-weight bearing and wearing a surgery boot for about six weeks after their surgery.
Osteotomy involves reconstruction of the joint by cutting the bone and moving it back into realignment, while the Lapidus procedure fuses the joint to keep it from moving.
However, these approaches tend to address the symptom, not the underlying structural problem. Scientific research reports that 50 to 78% of bunions recur if the root cause is not corrected.
Minimally invasive bunion surgery (MIS)
At The Bunion Institute, our minimally invasive bunion procedure provides the best possible surgical outcome for patients with mild to moderate bunion deformities. Our foot and ankle surgeons have advanced and developed different techniques and procedures for minimally invasive bunionectomy used worldwide.
In addition to better clinical outcomes, patients also experience smaller incisions, minimal scarring, and immediate weight bearing after surgery.
A review of the scientific literature found that MIS procedures were more effective than traditional surgery for mild to moderate bunions.
Lapiplasty
Lapiplasty is a new type of bunion surgery that offers a near-0% chance of bunion recurrence for severe bunion deformities. This technique uses advanced instruments to naturally and permanently correct the bony protrusion and straighten the big toe.
The lapiplasty 3D bunion correction addresses the bunion in three dimensions: sideways, elevated, and rotated out of alignment. It treats the bunion at the root — the unstable metatarsal joint — without cutting away any bone.
As an added bonus, Lapiplasty recovery time is only two to three weeks, compared with the six-week recovery time of open bunion surgery.
What causes failed bunion surgery?
There are at least 44 different types of bunion surgery that have been performed over the years, and many of them have their own reasons for failing. Obviously, the goal is to have a successful bunionectomy the first time as a failed bunionectomy takes a significant toll on recovery, negatively affects quality of life, can cause chronic foot pain, and requires a second correction surgery.
Some of the causes of bunionectomy failure include:
Undercorrection
Undercorrection occurs when the surgical technique used does not fully correct the bunion and a residual bony protrusion and pain remain after bunion surgery.
Overcorrection
Overcorrection can cause a new deformity where the great toe points toward the opposite foot—a hallux varus deformity.
Hallux varus can be treated early, but if allowed to persist, it may need joint fusion to correct it.
Nonunion and Malunion
Non-union and malunion of the bone are due to incorrect angles of bone incisions or insufficient fixation of a fusion site.
Hallux rigidus
Hallux rigidus is a rigid, non-bending big toe. Damage to the big-toe joint during surgery can lead to degenerative arthritis and big toe stiffness.
Patient-related factors
Failed bunion surgery is not always the surgeon’s or surgery’s fault. Patients who don’t follow post-surgery guidelines (such as those who restart sports too quickly) or have medical conditions that impact healing, may have a failed bunionectomy.
Wound healing complications
Chronic medical conditions — diabetes, rheumatoid arthritis, and peripheral neuropathy — can affect healing potential and greatly impact foot health post-surgery.
What is revision bunion surgery?
For patients who have had an unsuccessful bunionectomy or a recurrent bunion, revision bunion correction may be required.
The timing of bunion revision surgery is critical because corrections must be performed before the bone cuts (osteotomy) fuse and there is irreversible damage to the cartilage.
The goal of the revision is to relieve pain after bunion surgery and correct bunion deformities that remain after the initial surgery. Understanding why the previous surgery failed will guide the planning for the second surgery.
Revision foot surgery should be performed by a board-certified podiatry specialist or orthopedic specialist experienced in bunion revision surgeries. The vast experience and surgical expertise of The Bunion Institute podiatrists will help restore full motion, proper anatomical alignment, and quality of life.
Get the best bunion treatment, NOW.
Make my appointment nowChoose The Bunion Institute for your bunion surgery
If you’re experiencing bunion pain, we’re here to help. Our nationally recognized foot and ankle podiatry experts offer the most advanced bunion solutions and the highest success rates in the nation. With access to imaging technology such as X-rays and MRIs in many of our clinics, we’re able to take our patients through their entire bunion journey — no running off to other offices for imaging or testing!
Our team of podiatrists, physical therapists, and orthopaedic surgeons have decades of experience and are leaders in the research and development of most modern bunion protocols and technologies.
To schedule a consultation, please call (855) 814-3600 or make an appointment now.
The Bunion Institute and its parent organization (University Foot & Ankle Institute) are conveniently throughout Southern California and the Los Angeles area. Our foot and ankle surgeons are available at locations in or near Santa Monica, Beverly Hills, West Los Angeles, Sherman Oaks, the San Fernando Valley, El Segundo, the South Bay, LAX, Calabasas, Agoura Hills, Westlake Village, Valencia, Santa Clarita, and Santa Barbara.
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