Most patients wait far too long to undergo bunion surgery because they’re afraid. The hesitation makes sense: the thought of someone operating on your foot, the recovery time and potential complications are all valid concerns. But what many people don’t realize is that modern bunion surgery has evolved dramatically over the last decade. Today’s procedures are more precise; recovery times are often shorter and success rates are higher than ever before. Here’s what you need to know if you’ve been avoiding this procedure due to anxiety. We’ll share the facts you need to make an informed decision.
Bunion Surgery 101: What You Need to Know
Here’s the biggest misconception about bunion surgery: it should be your last resort, only considered when you’ve exhausted all other treatment options, or can’t stand the pain anymore. This outdated mode of thinking actually leads to worse outcomes because severely deformed, arthritic bunions are far more challenging to treat successfully than moderate ones that we catch at the right time. The truth is that you should consider surgery when conservative treatments haven’t provided adequate relief, and the bunion is significantly impacting your quality of life.
Candidacy Considerations ![Surgeons in the operating room]()
Who is a good candidate for bunion surgery? Considerations include how the deformity is affecting your life, and whether the non-surgical treatments you’ve tried have given you the relief you need. You might be a surgical candidate if you’ve tried appropriate conservative treatments for at least three to six months without adequate improvement. This includes custom orthotics, proper footwear, activity modifications and possibly injection or physical therapy. Foot surgery may be appropriate if your bunion pain significantly limits your daily activities, work or exercise routine.
Progressive worsening of the deformity despite conservative interventions is another indication that surgery may be necessary. If your bunion keeps getting larger, even with proper treatment, surgery can halt this progression and provide long-term relief. The development of secondary conditions such as hammer toes or arthritis in the big toe joint may also indicate that surgical intervention is needed to prevent further complications.
When to Avoid Surgery
You should avoid surgery if you have certain medical conditions that increase surgical risks. This treatment is also not for you if you can’t commit to the post-operative restrictions. Finally, if your bunions aren’t causing significant problems, you might be better served with continued conservative treatments.
Choosing the Right Approach to Bunion Surgery
The type of procedure recommended depends on the severity of your bunion, the condition of your joint, your age, activity level and other individual factors. A traditional bunionectomy, also called an osteotomy, has been the gold standard for bunion correction for many years. This procedure involves making a cut in the metatarsal bone, realigning it to a more normal position and securing it with screws or hardware. There are several variations of this procedure depending on where the bone cut is made. For mild to moderate bunions, that cut is typically made near the head of the bone. For more severe deformities, the cut may be made closer to the base of the bone, near the midfoot.
The advantage of this approach is that it’s a well-established procedure with predictable results when performed correctly. Recovery typically involves 6-8 weeks in a surgical shoe or boot, with a gradual return to normal activity over 3-4 months. However, the traditional bunionectomy only addresses the deformity on two dimensions. It moves the bone over and removes the bump, but it doesn’t address the rotation of the bone or the joint instability that initially caused the deformity. This is why some bunions can recur after traditional surgery—and why advancements have been made.
Lapiplasty: A 3D Approach
Lapiplasty represents a revolutionary advance in bunion surgery. It address the deformity on all three dimensions, addressing the sideways deviation of the bone, its rotation and its elevation. More importantly, it stabilizes the unstable joint that’s the root cause of most bunions. This is what makes Lapiplasty stand out: instead of just cutting and moving the metatarsal bone, the procedure fuses the joint in the midfoot, providing a stable foundation that prevents the bunion from recurring.
The procedure uses specialized instruments to precisely rotate and realign the entire metatarsal bone to its original and correct position. Then, titanium plates are used to permanently secure the correction, providing much more stability than traditional, single-screw fixation. Also, patients can often begin walking within days, rather than weeks of this surgery—without compromising the results! Recovery is often faster and more predictable than traditional bunion surgery. Most patients return to regular shoes around 6 weeks after their procedure, and full activity by 3-4 months. The recurrence rate is also significantly lower because the procedure addresses the bunion’s root cause. However, this approach isn’t appropriate for everyone. Lapiplasty works best for those whose bunions are caused by instability in the midfoot joint.
MIS
Minimally invasive bunion surgery is another recent advancement in bunion correction. The technique uses specialized instruments and smaller incisions to perform the bone cuts and realignment. The advantages of MIS include smaller scars, less soft-tissue trauma, reduced post-operative pain and an often-faster recovery. Some patients can return to regular shoes in as little as 2-3 weeks. However, MIS techniques involve specialized training, and they aren’t appropriate for all types of bunions. Severe deformities or bunions with significant arthritis might still require traditional open surgery for optimal outcomes. The key to finding your best approach is to work with an experienced surgeon such as Houston podiatrist Dr. Andrew Schneider, who will look at the complete picture of your health and guide you towards your ideal approach to bunion surgery.
Lasting Bunion Relief in Houston, TX
When patients come into our practice seeking relief from bunion pain, we often suggest conservative treatments to begin with. However, when these options fail to provide sufficient relief, or fail to stop progression of the deformity, we will likely recommend bunion surgery—and help guide you towards the approach that will deliver optimal results for your unique condition. They key to remember is that surgery doesn’t have to be frightening: together, we will work to help you find your ideal treatment, maximizing outcomes and minimizing the disruption to your daily life.
