What is Bunion Revision Surgery?

When you’ve suffered a failed bunion surgery, you need the confidence of experienced care. Our board-certified surgeons are no strangers to bunion revision surgery. In fact, revisions account for almost one-third of our bunion surgeries.

We think this is an appalling statistic and we hope the information below will help you avoid being a failed bunion surgery statistic.

Why Do Some Bunion Surgeries Fail?

Many podiatrists will take a one-size-fits-all approach to bunion surgery. Although bunions might appear simple from the outside, they are actually one of the most complex structural deformities afflicting the human foot.

Correcting a bunion can be incredibly difficult, and it’s not uncommon for the first attempt to fail.

If a bunion surgery fails, it’s usually because the surgeon focused on the superficial, cosmetic issue, and failed to locate and correct the mechanical cause of the bunion. Unfortunately, there is no quick fix when it comes to bunions, and there are several ways in which an inappropriate surgery can fail. 

 

What are the Signs that a Bunion Surgery has Failed?

A botched bunion surgery could lead to the return of the original bunion, as well as many other painful problems that can impact your ability to work and play. Here are some of the most common undesirable outcomes we’ve seen in our office.

• Recurring Bunion – The bunion has slowly reformed over time.
• Shortened Toe – The big toe has been shortened too much.
• Hallux Varus – The big toe has drifted away from the lesser toes.
• Stiffness – The big toe joint has lost its mobility.
• Arthritis – The big toe joint has developed arthritis.

If you’re dissatisfied with the outcome of your recent bunion correction surgery, contact UFAI today to schedule a consultation with the country’s leading podiatric surgeons.

Recurring Bunion

If your bunion comes back after surgery, that likely means that the underlying problem was never corrected in the first place. More concerned with volume of patients than with quality of care, many surgeons offer quick-fix bunion “corrections” that only address the cosmetic issue.

However, bunions are not a cosmetic problem; they’re structural deformities. To properly correct a bunion, the surgeon must correct the misalignment of the bones, in addition to shaving off the head of the bony bump.

Bunions are caused by excessive motion in the bones of the midfoot. When those bones spread apart, they force the first metatarsal out of position, resulting in that characteristic bony bump.

At UFAI, we typically use a Forever Bunionectomy, which includes an osteotomy (a bone cut) and a fusion (bone mending) procedure to reduce excessive motion and prevent recurrence.

Shortened Toe

Osteotomy and fusion are two techniques that are commonly used in bunion correction surgeries. Both of them tend to leave the big toe a little shorter than normal. However, this shortening should not impact your ability to stand or walk, and it should not cause pain.

If the toe has been excessively shortened, it could affect the entire mechanics of the foot, impairing normal foot function and causing painful complications.

To correct this issue, our surgeons will typically reverse the original surgery and start again with an individualized plan to regain the lost length. Some techniques that will be considered include:

• Bone grafting
• Bone fusion
• Bone cuts designed to lengthen
• Generating new bone growth

Hallux Varus

Hallux Varus refers to a structural deformity in which the big toe is pulled away from the lesser toes. This is almost always painful, and makes it difficult to wear normal footwear. Hallux Varus results from a muscular imbalance, which is sometimes a complication of failed bunion correction.

What complications could cause Hallux Varus? Here are some of the most common issues.

• The ligaments were excessively tightened.
• A tiny midfoot bone called the sesamoid was removed.
• The surgeon shaved away too much of the bone from the bunion.

Correcting Hallux Varus usually involves undoing a lot of the previous work and re-correcting the bunion properly. Occasionally, revision surgery calls for the big toe joint to be fused in place. This will limit mobility in the big toe, but it can eliminate the pain of excessive motion, and prevent further problems from developing.

Stiffness

Many, if not most, patients experience some stiffness in the big toe joint following bunion correction surgery. In most cases, the larger the bunion, the more stiffness you can expect.

Wiggling the toe joint during recovery can help to break up the adhesions (scar tissue), which is why UFAI has designed bunion correction procedures that encourage movement and avoid casting as much as possible.

If your foot was recently immobilized in a cast during your recovery from bunion surgery, then you might be suffering from greater stiffness than normal. To correct this problem, we can try one of two non-invasive techniques.

• Manually work the joint under anesthesia.
• Use steroid injections to dissolve adhesions.
• If both of these fail to produce results, there are a couple surgical techniques that can help.

Arthroscopy. We can surgically excise the scar tissue with a minimally-invasive arthroscopy. In an arthroscopy, the surgeon is guided by a slender, flexible camera, which is inserted through small incisions in the toe.

External Fixator. We can also surgically mount and external fixator to the joint. The device stretches the joint from outside the foot, pulling scar tissue apart and enabling a greater range of motion.

Arthritis

In a small number of cases, a failed bunion correction can lead to the sudden onset of late stage Hallux Rigidus, or arthritis of the big toe. Arthritis occurs when the cartilage that protects the joint from friction deteriorates. It’s a painful condition that also causes swelling, grinding, and bone spurs.

Arthritis can result from misplacement of the bone during a failed bunion surgery. It can also result from an infection that may have developed after the surgery, or bone death.

Unfortunately, there is no cure for arthritis. However, simply removing the bone spurs can provide pain relief. Your UFAI doctor may recommend surgery to re-align the toe bones. Some patients may be good candidates for fusion in the big toe joint. Eliminating motion in the joint will eliminate the pain caused by arthritis.

Why Do So Many Patients Come to UFAI for Revision Surgery?

Simply put, peace of mind.  It pains us that so many people need to go through surgery a second time.

As an internationally recognized Center of Excellence for our expertise in bunion surgery techniques and research, our surgical team is experienced in all 44 types of bunion surgery that have existed over the years. We are also known for our refined techniques and teaching them to other doctors in in the United States and Europe.

Your surgical correction will be highly individualized to address the deformity, correct the underlying cause of the bunion, and prevent recurrence. No matter where you are, this is what you should make sure you are getting if you are going to have surgery the very first time or if you require revision surgery.

 

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