The Center for Podiatric Care and Sports Medicine

How Often is Bunion Surgery Successful? Predicting Whether a Bunion Will Return

Posted by on Friday, February 16th, 2018

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Getting surgery to remove an extremely painful bunion may seem like an easy decision. But what if you were told the painful bunion you sought to remove had a chance of coming back again months later? Studies show recurrence rates as high as 25% for bunions. In fact, here at the Center for Podiatric Care and Sports Medicine, correcting failed bunion repairs done by other local surgeons accounts for nearly a third of our business.

However, our center’s 40+ years of bunion surgeries mean we’re better at selecting the right candidates, more adept at operating, and skilled at identifying who is at risk for failed surgery. This means we can give you a more accurate answer if you find yourself wondering, “How often is bunion surgery successful?” In fact, a new study published in The Journal of Bone & Joint Surgery identifies one tell-tale way of predicting whether your bunion will return over time.

Get back on your feet after bunion surgery.
Get back on your feet after bunion surgery. Image Source: Pixabay user ashokorg0.

Are You a Candidate For Bunion Surgery?

We never take the decision to undergo surgery lightly. In the absence of pain, patients can often manage and limit the deformity non-operatively through the use of custom orthotics, bunion padding, stretches, night splints, and proper footwear choices. The American Academy of Orthopaedic Surgeons says the best candidates for bunion surgery include patients who have one or more of the following symptoms:

  • Significant pain that limits their ability to walk more than a few blocks and fit into reasonable shoes.
  • Chronic big toe inflammation and swelling that does not respond to rest or medication.
  • Visible toe deformity, such as a drifting in of the big toe and crossing over of the little toes.

On the other hand, there are a few reasons you may not be a good candidate for bunion surgery. If it’s just a matter of appearance, the surgical route may leave you with more problems than you had before. Though complications are rare, there have been reported cases of side effects from anesthesia, nerve damage, poor wound healing, stiffness, restricted movement, and infection. There are greater risks for patients with diabetes, cancer, AIDS, lupus, or an otherwise weakened immune system. Patients who are not willing to stay off their feet, reduce their workload, and take care of themselves during recovery stand a better chance of suffering complications.

Are Your Expectations For Bunion Surgery Realistic?

It is important to have realistic expectations about your bunion surgery. Though some bunion surgeries are described as “minimally invasive” and can be done on an outpatient basis with no required hospitalization, such an operation is not a quick fix. Even the newest bunion procedures involve six weeks off your feet. You may not return to all your normal activities or feel completely normal for up to six months. You may not be able to wear narrow, pointy shoes even after you recover.

Postoperative X-Rays Taken Immediately After Bunionectomy Estimate Risk

If you take non-weight-bearing X-rays right after completing surgery, they can give you an idea of whether you’re at risk for a bunion recurrence, according to South Korean investigators at Yeungnam University Medical Center and Injie University Seoul Paik Hospital. Further studies are needed, but researchers hope the use of X-ray predictors during surgery can minimize the recurrence risk further.

In their study of 93 patients and 117 bunion-afflicted feet, researchers found a 17% return rate for bunion deformities measuring 20 degrees or greater within two years of the original surgery. Bunions were 28 times more likely to recur when postoperative X-rays measured eight degrees or larger. Subsequent scans showed hallux valgus angle (HVA) widening over time in patients with recurrent bunions, whereas patients whose angles stabilized at six months tended to stay the same.

Other risk factors for recurrence included:

  • Preoperative HVAs of 40 degrees or larger
  • Certain positioning of sesamoids beneath the joint prior to surgery

With this new research, we hope to be able to more accurately predict the risk of bunion recurrence following surgery and even prevent such recurrences altogether.

NYC Bunion Correction

Get a professional opinion on the status of your bunion to learn what options are available to you. There is no reason to live with pain or limited mobility when some of the best bunion repair surgeons and foot specialists are right in your backyard. Dr. Josef J. Geldwert, DPM, and his team maintain offices in Manhattan and White Plains. Contact us today to schedule your appointment.

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If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.