Bunion Surgery questions

Foot care
1

Hi guys,

I am looking for advice relating to bunion surgery. I have bunions on both feet that have been deemed somewhere between moderate and large/severe. In the left foot I have significant pain under the foot (between 1st and 2nd toes,  that I really need to get fixed. The right foot - although the more pronounced bunion - is not giving me much pain.

I was an active tennis player (4-5 times a week) prior to the pain developing in the left foot, so my goal is to get back playing tennis pain free and in the shortest possible timeframe.

Initially I did some research on the Internet and from what I found, 3 months seems to be the minimum recovery time from Bunion Surgery – which I would be happy with.

Anyway, I went and saw a Podiatric Surgeon 2 months ago and he suggested my bunions are not that bad and it would be "stock standard" bunion surgery and I would be back playing tennis in maybe 6 weeks or just over. He suggested it would be fine to do both feet at the same time and I would be in a wheel chair for the first 2 weeks - which I would happily accept.

I asked him why he believes the recovery time to be quicker than what I’d read about and he said the approach that Podiatric surgeons take to the surrounding tissue is more delicate/gentle (than Orthopedics) and therefore less recovery time is needed. I haven’t found any literature to back this up, but he seemed very confident and a very kind, gentle and caring man. I liked him very much and felt comfortable putting my feet in his hands – literally and figuratively :-)

He also suggested I should get a 2nd opinion and he would answer any further questions I have.

Since then, I have seen 2 Orthopedic surgeons and have been told the rehab would be more like 6-9 months and it would be 1 foot at a time. This was quite devastating news – to say the least :-(. When I told them that I had also seen a Podiatric Surgeon it was practically implied that they are witch-doctors and shouldn’t be listened to. I say that in jest, but they were less than supportive of Podiatric Surgeons in any case.

Now, based on articles I have read on the Internet, there is this obvious war (for want of a better word) between Podiatric Surgeons and Orthopedic Surgeons that can add some confusion to it all as well – which is a shame as I understand there are very talented surgeons in both fields.

So, should I be putting my faith in someone that I guess is telling me what I want to hear, i.e. the shorter healing time? Or go with the tried and true Orthopedic Surgeons?

Is there anything to suggest Podiatric Surgeons are good/bad at what they do in comparison to Orthopedic Surgeons?

Is 6-8 weeks a realistic time frame to be back to normal and/or playing tennis?

I am looking for advice from people who have had bunion surgery but also If there are any doctors that can offer impartial advice, i.e. not involved in the Orthopedic vs Podiatric surgeons war – that would be greatly appreciated.

This is a huge decision to make and I’d like to get it right first time.

Thanks in advance :-)

2

There is bad podiatrics and bad ortopedics, there is good podiatrics and good ortopedics, it's all the same. It must be good specialist who is doing this kind of operations on the regular basis.

8 weeks realistic,I have podiatric,love it! No pain, after 2 weeks usial shoes, going to work now.

But, there is Murphy Law. So than I decided to do after 6 weeks another leg, he said not to do it now, because I am going on vacation and must be in perfect shape. With this type of operation nobody knows how it will be. Even I have fantastic results with my more problematic leg. He also did not want to do both legs the same time.

we like to believe in good, but need to be realistic.

i was walking in the shoe from the first day. Never use crutches or wheelchair. I think we have better system with this operation in America.

my doctor never promise me anything, was realistic and I think it's right.

Good luck!

3

Hi there,

Not sure you're going to like my answer.  I, too, WAS an avid tennis player...3 to 4 times per week.  I had bunion surgery on my left foot...fairly severe deformity...2 pins in my big toe and one small one in my second toe.  The surgery was 10/16/2014 so about six months ago.  I still have considerable pain and swelling in my foot and will need additional "revision" surgery to correct the original surgery.  Make sure you are comfortable with the surgeon or podiatrist you choose.  I went against my better judgement and decided on someone I didn't like nearly as much as another fellow (podiatrist).  My gut feeling is that podiatrists have much more experience with bunionectomies than orthapedic surgeons.  Make sure you do considerable research and get recommendations from as many people as you can who have had surgery from the respective parties....look everywhere for reviews...do a comprehensive search.  The jerk who did my surgery lied to me on a number of occasions AND blamed me for the surgery not working.  "You didn't stay off your foot for seven weeks."  Well, of course I did.  "You didn't follow the physical therapy routine."  Again, of course I did.

I am no stranger to surgery.  I'm and ex-college jock and avid tennis player, basketball player et al.  I had ACL surgery 8 months before the bunionectomy and rotator cuff surgery four years ago (ex baseball pitcher).  I had no problem with either the rehab or pain from these.  I KNEW right from the start that the bunion  surgery wasn't right.  Another dirty little secret is NERVE DAMAGE.  My foot is still numb and burns considerably especially when I try to sleep....TRY being the operative word.  Nerve damage happens frequently with bunion surgery but obviously, surgeons don't exactly advertise that...it's every man for himself.  Do I sound cynical??  you bet I do.

When I walk on my foot, it feels like it's broken.  My next surgery is to have the pins removed, a bracket to replace them and a an artificial hinge put in to give the toe joint some "bend." because there is no bend to it now which causes tremendous stress on the rest of my foot...basically this has been a TERRIBLE NIGHTMARE...and I'm pretty sure the surgeon had alot to do with it...Unfortunately, I'm in Indiana USA and the laws are stilted heavily towards doctors in malpractice cases because the former governor was a surgeon.

Most likely, if you pick the right surgeon, you won't have all the complications I've had or the misery...just be SURE you do your homework in picking the right person to do the job....it's VITAL.

good luck!

4

In my experience use an orthopedic surgeon who is experienced in such ops - look at on line reviews. 6 to 8 wks is not realistic. I'd say 6 months for full on tennis. After 1 year you should have full mobility to do all sports. After 6 months i could do all sports but still had some stiffness, 12 months all good except for residual nerve damage in 1 foot which is annoying but not as awful as one of your respondents. Do both feet at once - why go through it all twice. Just make sure you only do the feet that really need to be done.

5

Thanks Irina, Redstone and Lise for your responses.

I live in New Zealand and it seems Podiatric surgery really hasn't taken off here and is frowned upon by the Orthapedic communities. It's a shame as it feels to me like they're (Podiatric) the ones who seem to be pushing things in terms of better procedures etc. based on what I'm reading on the Internet. That said it's probably their own marketing spiel anyway.

Redstone, sounds like you've had a bad run which I'm sorry to hear. I take on board what you say about going with a surgeon you trust and feel comfortable with.

As for the research and reviews etc youve suggested finding, I;m not sure how to go about that. Certainly on New Zealand websites i cant find anything in terms of reviews for Orthapedic or Podiatric surgeons, so I;m not sure how to go about that.

Obviously the surgeons have their own testimonials but you have to take those with a pinch of salt I guess.

I'm certainly not at all enthusiastic about a 9 month rehab knowing that I'll then most likely to have to get the other one done too.

Oh well, I'll keep researching but either way I go I'm sure it'll be something I won't regret.

Thanks again guys and good luck Redstone, I hope it all comes right for you.

6

I started my research one year before operation. I was talking about it with my friends, clients, literary with everyone. Surprisingly , a lot of people were doing this operation. I am from St Louis, MO, my town has population more than 2 millions. But only two names were repeated several times! Can you imagine ?

So, one was podiatric , another- orthopedic. Both have nice reviews. It was hard to choose, they both were confident, both didn't promise fast recovery. 

I picked podiatric, may be because we both were born in the same year, may be jbecause just before I made my decision, my friend had bad operation with other guy. She was saying it's not his fault, but I choose the other guy.

so, my advise to you- talk, ask around and you will get a lot of information.

7

Thanks Irina, will do :-)

8

One more thing dcs, I'm in Melbourne, Australia and there are online forums for various specialists - people rate them and leave feedback. I don't know if a trip to Australia is an optiion?  Here the general opinion seems to be in favour of orthapedic surgeons, but certainly the ones that specialise in bunions.   There is one guy (name eludes me at moment but I can find out) who everyone seems to go to (I didn't in fact).  Lise

9

Maybe it was MIS he specialises in?  Minimally invasive surgery?  In which case there is usually less pain and less nerve damage.  It is vital to get recommendations.  I was recommended a surgeon in London and the lady was operated on by him and was very happy indeed.  

10

Hi, I am in UK, four years ago I was offered chevron surgery by a podiatrist, as I too have a spur growing between my big toe and 2nd.  I was not confident with him, really didn't think I could consider the op so tried for four years to elevate the pain with various toe separators etc.

It got too bad and so I went to a nhs orthapadic surgery.  He offered scarf and akin surgery with lesser foot fusion and k wire for middle hammer toe.  I checked online to find out more about the surgeon, seemed good where he had previously worked, basically his cv.  Also asked the secretary, and found he is a teaching surgeon and writes papers.  But I couldn't get any info about his success rate.  I questioned the type of op that he does compared to what was offered before and he said that scarf Akin surgery is far more successful.

My op was done on 31 March, so almost 2 weeks ago.  It's been quite painful, especial first week.  This second week slowly improving, I get tingling, sharp pain, and burning at different times and from different places (not just the surgery area).

My surgeon was realistic about recovery:   Very painful first few weeks, stitches out 2/3 weeks, k wire removed 4-6 weeks, six weeks wearing a wedge shoe, after then could be in a normal shoe but wider fitting.  Then gradually improve until in 6 months should be recovered, though it will be 12 months till properly back to normal.

I think there are good and bad surgeons/ podiatrist, but it's such a major surgery think I would rather use the orthapadic surgeon in a hospital.

Good luck. 

 

11

Thanks Barbara,

This highlights another confusing part for me. The 2 people I have had consultations with are both taking a completely different approach too. One wants to do a Lapidus surgery and the the other an Austin precedure with a bunch of other little procedures thrown in, so youre not even comparing like ofr like when choosing a surgeon. I'll keep researching what I can anyway and good luck with your recovery :-) 

12

Good luck, I haven't heard of those methods.  Maybe didfer not in NZ

 

13

Lapidus is not for the faint hearted, and the physio was most annoyed with me for having both done at once, check it up on the web. I'm 5 months in, and slowly getting back to normal, main problem i find is that  you get muscle wastage from having your feet up for so long, and I didn't exercise properly during the recovery period. would i start playing tennis now?- no as i don't like the sport, walking 5 miles, standing on my feet all day - no problem. Is it stil painful - yes, i have good days and bad. but i will be back to the 20 mile hikes this summer, so long as i can get into the boots.

Caroline

i had othopedic, i didn't know there was a choice. find out who your local sportsteam would use, that should give to a clue.

14

Ur right to get different opinions for all reasons !

In Canada I would not be able to go to a podiatrist for surgery as it would cost me too much money

And I can have it done by an orthopedic surgeon

And all is paid for !

I have had one foot done and that surgery removed removed just the bump nothing else and at that time the surgeon said it would take years for the bump to return ! Everything went well had surgery Dec 5/2014 and it was about 2 - 4 week recovery for that simple surgery although cos it was my right foot I couldn't drive . Foot looks good but of course it did not address the toe drifting over so who knows , I am 60 yrs old and if things get worse I can always have a revision done !

Next surgery was april2/2015 and a different surgeon who I asked to make my toe straight so he did a chevronostiotomy ( big word) but just breaks the toe v shaped and realigns and they always take off the bump too , no problems with this surgery but

In a plaster cast now for 8 weeks and only heel walking but little to no pain now and getting around fine and dandy . Toe is nice and straight and I wish really I had gone the other route with the other foot .

My bunions were consider mild to moderate so hope this helps with your descision as what to do. There is down time no matter what you choose but remember

It's up to you not a doctor to decide what is best necessarily . Good luck and if yu have any more questions I would be glad to try and answer 😄

15

Hi Lise,

I had a terrible experience with surgery for bunions and hammertoes and am looking for a new surgeon. I can't seem to find any online reviews. Could you send a link, please?  I am also in Melbourne.

Happy to give advice whom not to use if anyone here is interested. 

16

Hi Lise

Would love to know the name of the doctor in melbourne.

regards Julie 

17

hi. Would love to know who not to go to in Melbourne. 

Regards julie

18

Do not use Gerard Bourke. There are also others I would not use. Depending on the extent of the surgery, I would recommend Terence Chin. He does very good work. Paul Rice has also been recommended. For 'salvage' surgery, I would only suggest the most experienced. Will Edwards or Mark Blackeney are the ones I am looking at. I hesitate with podiatric surgeons also. Although I would have been better off using one given my results. In any event, you must use a foot and anle specialist. 

Why does no one else name the surgoens? It would really hemp when rying to get information.

19

So, I'm having bilateral Austen bunionectomies this Friday. I'm using a podiatric surgeon - Andrew Kingsford, who I have worked with as an anesthetist for almost a decade. I also work with orthopaedic surgeons, who are all giving me a hard time for going to a podiatric surgeon, which they consider akin to blasphemy!!

I also have a podiatrist friend who was training to become a surgeon but hasn't persisted, who has worked with both pod surgeons and orthopods. It IS a different procedure, with a lot less tissue destruction. One screw and a K-wire with the pod surgeon vs a plate and several srews with the orthopad. 2-3 weeks off feet vs 6 weeks. WIth me, time is money, work wise and in terms of being abe to look after my family. Surgery with a pod surgeon is not covered by health funds, and being medical I normally don't pay out of pockets with surgeons or anaesthetists. That aside, I am not sure I would have made any other decision. Andrew Kingsford is an excellent surgeon, very precise and exacting and I trust him to do my surgery. I can also give you then names of the foot and ankle surgeons that I have found to be or heard are good. 

I can let you know how my surgery goes, but from my experience, he would be my fisrst go to in Melbourne. He's also a great guy to work with. 

20

All the best for your surgery.

I have just seen a Melbourne Orthapadic Surgeon who has recommend  I have Surgery on  surgery on my 2  bunions (bilateral sacrf & akin ostetomies).Online  there seems to be very few review by patients on surgeons who have performed this procedure.I am particularly interested in surgeons who offer the option of  Minimally invasive surgery in addition to traditional surgery, as well as understand how MIT surgery differs from or surgery done by Podiatric surgeons?

I would appreciate any recommendation/advice on surgery options/choice of surgeons.