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Bunion Surgery questions

Posted , 23 users are following.

dcs
dcs

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 :-)

0 likes, 36 replies

36 Replies

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  • kim92989
    kim92989 dcs

    Posted

    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 😄

  • dmr1410
    dmr1410 dcs

    Posted

    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.

  • doolittle
    doolittle dcs

    Posted

    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. 

    • kiwi2
      kiwi2 doolittle

      Posted

      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.

    • doolittle
      doolittle kiwi2

      Posted

      Thank yuo for the kind wishes - 2 sleeps to go!

      I know that the scarf akin means non weight bearing for 6 weeks - it involves a z incision in the bone. With the Austen you can weight bear and be mobile straight away as it is more mobile, but I know it is only suited to mild/ mod bunions. I think my surgeon modifies the op, or does a lapidus procedure if it is more severe.

      I would definitely recommend seeing Dr Kingsford for a second opinion and to compare recovery options. Or you can PM me and I can recommend some orthopods, but they tend to do the Scharf Akin procedures as a rule, and as I said, its not stable for weight bearing until it heals, and it invoves more tissue disruption. I had a leaflet with pictures of what the different surgeries involve but no idea what I did with it! This is a summary of the main differences although the pictures I had were clearer! [b]http://www.bunioninstitute.com/treatment/types-of-bunion-surgery[b].html

      Yes, I am biased, but I believe that I have done my homework. I will update over the weekend with my surgical experience.

    • doolittle
      doolittle

      Posted

      I'm now 36 hrs post op. The first 30 hours were fine as the nerve blocks were working but it became more painful this afternoon so I've taken some endone and OxyContin. I'm icing my feet and I've had them up all day other than bathroom breaks. I'm very happy with how it has gone so far, hey found that the cartilage had become detached in both feet which would explain most of my pain. Just a single screw in each to hold the bone. Was looked after really well by the hospital.

      I'm happy the surgery is behind me!

    • kiwi2
      kiwi2 doolittle

      Posted

      Good to hear of your progress.

      Please can you recommend some orthopods who use Minimally invasive surgery?

       

    • doolittle
      doolittle kiwi2

      Posted

      I don't know who does minimally invasive surgery but know that dr harviner bedi is a very highly regarded foot and ankle surgeon and he would be my first choice. Dr Daniel goldbloom also worth considering as he seems to use a chevron technique similar to the podiatric surgeons.

      However, due to the differences in surgical techniques, recovery likely to be longer than with dr Kingsford. I cancelled my appointment with the orthopaedic surgeon when he secretary told me I would be on crutches for 6 weeks!

      I'm hobbling about when I need to but resting, it's sore but already improving. I see my surgeon on day 5 (Wednesday)

    • kiwi2
      kiwi2 doolittle

      Posted

      Like you in researching options I became aware of the chevron technique which as you mentioned seems similar to the podiatric surgeons. In addition I have read a few Australian Orthopedic surgeons websites who claim to use recently developed (last 5 or so years) minimally invasive surgery techniques.  On one website the surgeon makes reference to both the Chevron and Akin procedures under the topic of  MINIMALLY INVASIVE BUNION CORRECTIVE SURGERY.  Hence my question asking if you had any experience or information with minimally invasive surgery.

      Emis Moderator comment: I have removed the link(s) directing to site(s) unsuitable for inclusion in the forums. If users want this information please use the Private Message service to request the details.

      http://patient.uservoice.com/knowledgebase/articles/398331-private-messages

    • joolz1416
      joolz1416 doolittle

      Posted

      Very interesting reading of your experience so far. Any updates on your post op recovery?

      I am deciding whether to participate in a clinical trial in Melbourne which is for post op pain relief (dexmetatomadine patch) post bunion surgery. The surgeon performing the bunionectomy is Mark Gilheaney (Podiatric) Unfortunately the trial will only allow for unilateral bunion. My bunions are moderately severe. Any thoughts/info on this podiatrist? He uses minimally invasive technique and claims very fast recovery times.

      Any info much appreciated!

    • doolittle
      doolittle joolz1416

      Posted

      He works at one of the hospitals I work at and the pod surgeon I work with and the theatre staff say he's good. He will use the Austin technique or a variant of it for mild to mod bunions and your recovery will be similar to mine (back in shoes at 3 weeks, and at work and walking 30 mins a day from 3.5 weeks for me)

      I've recommended the trial for friends if money is a concern. Personally I think there's a lot to be said for doing both feet together!

    • tln
      tln doolittle

      Posted

      Thank you for sharing your experience and advice, which is very interesting to read. I hope you are recovering well? I have pretty severe bunion and one side it starts to cause a hammering toe. My surgeon Geoff Tymms is suggesting a bilateral 1t MTP fusion and 2nd PIP foot. It looks like they are quite full on!! I would like to have one or two more opinions and also explore the Minimally Invasive Surgery option. So I think I will try to see your pod surgeon but I also found a orthopedic surgeon that says he has a special interest in MIS. His name is Sasha Roshan. Do you have any advice about this process and these two surgeons? Much appreciated!
    • kiwi2
      kiwi2 tln

      Posted

      After consulting a podiatric surgeon and two orthopedic surgeons decided to go with Sasha Roshan as I felt the nature of my bunions were suited to MIS surgery. (I think suitability is important).  He performed bilateral sacrf/akin using MIS.  In addition he performed a ligament release and tightening procedure, which required incisions, as this is not able to be done by MIS.  First three days the nerve block, Endone and OxyCoptin were used to stay on top of the pain. After this I used Panadol and Nurofen as I tolerated this better. After two weeks the pain has now subsided: the bandages came off: stitches removed and crutches returned . Only swelling evident is  around the big toes (which Sasha put down to compliant recovery patient)  which are also quite stiff. The 1st Toe is straight and parallel with  2nd toe. Still wearing the boot and starting exercises under physio guidance.  I can’t speak highly enough of Sasha Roshan and all his staff.  
    • dmr1410
      dmr1410 tln

      Posted

      After consulting with four orthopedic surgeons, I have had my 'salvage' surgery done with Will Edwards and can't recommend him highly enough.

    • stacey71106
      stacey71106 doolittle

      Posted

      Hi there,

      I'm currently looking into choosing a surgeon to have this operation. I would like to consult with a number of surgeons prior to deciding on "the one". Unfortunately every surgeon I call there is $250 charge just to see the surgeon. How has everyone else been able to get around this? It could cost me a small fortune simply finding the right person. Any help much appreciated.

      I live in Melbourne.

    • dmr1410
      dmr1410 stacey71106

      Posted

      Not sure I can help - it cost me a small fortune that I wish I had spent the first time around. Happy to give my feedback privately on the ones I saw in Melbourne. All totalled, there are 6, including Bourke, whom I certainly would not recommend. 
    • LUI83
      LUI83 dmr1410

      Posted

      Hi there,

      I was wondering if you could share the list of specialists you visited and what would be the recommendation or which one will not recommend apart from Bourke.

      I'm going to start getting points of view regarding going ahead with surgery or not. Thanks a lot.

    • dmr1410
      dmr1410 LUI83

      Posted

      I would go to Will Edwards. Another is Paul Rice. there are others I have heard of or contacted, but either wouldn't recommend or don't know enough. I'd probably recognize the names. Blackney has mixed reviews. I saw him for a consult. But it's a bit of a factory practice - you have to go on a Tuesday fo an intake session with the nurse. Chin, who is in the same rooms is good, I have a friend who loved him, her sister satisfied but not thrilled. I don't use him as I wanted someone more experienced as mine was a salvage job. It really depends on how complicated your situation is - just bunions, what severity, hammer toes, etc. I was trying to fix a mess that will probably require another surgery.

      Hope this helps. Feel free to ask other questions - happy to help as it is very hard to make a decision.

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