When bunion surgery does not go right
Maybe around 5% fall below the ideal aims of success. Data is published by the College of Podiatry PASCOM-10.com annually so this is not just a guess. Over the last 7 years, 25000 bunion surgeries have been performed where 93% believed their expectations from surgery had been met. There is a common problem that arises with the best surgery;
pain and stiffness
Julia was keen on tennis and her surgeon selected an osteotomy. An osteotomy is perhaps the gold standard with the aim of retaining joint movement. Sometimes the joint stiffens and can become painful.
Loss of joint quality is not uncommon and can progress as we age. The give away is how much the first toe joint hurts during normal activity. Too much pain and jamming means the toe may have a problem. An injection of steroid might be recommended first before surgery, unless the end stage has been reached, but can be found within the guidelines suggested by the National Institute for Care and Effectivness (N.I.C.E.) as a conservative treatment.
Julia had this type of damage before surgery so she had around a 70% of success of improving even though there was loss of joint quality. While joint movement might be less than ideal, pain on movement is undesirable. When pain on movement arises after surgery, it might be back to the drawing board.
Share your own experience if this has happened to you or a patient and let me know what you did next.
Patients need to be aware of the risk up front as none of us want repeat surgery, but, if we do have to return to the operating theatre, then it is better to be prepared ahead as part of good consent process.