Revision Surgery

When Bunion Surgery Does Not Produce the Expected Result

A failed procedure can create structural, functional, cosmetic, and emotional problems, and many patients delay seeking help because they are afraid of repeating the first experience.

"Dr. Moy's role is to restore the alignment and function of the foot. The patient's role is to protect that work and allow it to heal uneventfully."

Dr. Moy frequently evaluates patients with recurrent or incompletely corrected deformity, increasing pain, unsightly alignment, transfer pressure, second-toe problems, joint stiffness, hardware irritation, chronic swelling, difficulty walking, and fear of undergoing another operation.

How Is the Failure Evaluated?

Weight-bearing X-rays, front and side views. Dr. Moy examines the intermetatarsal angle, hallux alignment, previous surgical site, first-metatarsal length and elevation, sesamoid position, joint congruity, arthritis, healing, and hardware, then examines the foot directly and puts the joint and surrounding structures through range of motion.

Can the Foot Be Reconstructed?

Many failed bunion procedures can be improved when enough usable bone, joint structure, capsule, tendon, ligament, and surrounding soft tissue remain. When excessive bone has been removed from both sides of the joint, the natural joint may no longer support Dr. Moy's reconstructive approach. In that unusual situation, he may recommend a surgeon who specializes in another form of salvage reconstruction.

What Type of Revision Is Required?

There is no single revision operation. Depending on the case, it may require repositioning bone, correcting under- or overcorrection, restoring the metatarsal-phalanx relationship, mobilizing the sesamoids, releasing scar tissue, rebalancing tendons and capsule, removing hardware, smoothing residual prominences, and correcting associated second-toe or transfer-pressure problems.

Is Recovery More Difficult?

Revision surgery may be more complex and time-consuming for the surgeon, given altered tissue planes, scar tissue, changed anatomy, and existing hardware. Despite that, the patient's recovery generally follows the same approximate six-week framework as a primary procedure, and can still be virtually painless.

The Patient's Role

The surgeon reconstructs; the patient must allow the reconstruction to heal. Excessive activity, premature pressure, failure to use the boot, and disregard of postoperative positioning or motion instructions can alter the final result.

Sherry's Case

Sherry had bunion surgery elsewhere that did not correct her deformity. Dr. Moy performed revision surgery to reconstruct the correction that the original operation had failed to achieve.

Seeing both results side by side, the outcome of the original operation and the reconstruction that followed, makes it easier to judge what a revision can actually accomplish, rather than relying on a description alone.

If you've had bunion surgery before and are still experiencing pain or deformity, bring your prior operative reports and imaging to your consultation so Dr. Moy can evaluate what happened and what options are available.