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Frequently Asked Questions

Have questions? Expert doctors answer your questions about the Arthrex Minimally Invasive Bunionectomy.

Bunions and Treatment Options

Transcript
Richard Lamour, MD, Discusses the Arthrex Minimally Invasive Bunionectomy

The 2 most common symptoms of a bunion are pain and difficulty with shoe wear. Pain can vary from burning to electrical symptoms to sharp pains. There are times when people have so much debilitating pain that they can’t even wear regular shoes, and they’re kind of relegated to wearing wider toe-box shoes, slippers, or other shoes that are just softer.

There are some misconceptions with what a bunion actually is. A lot of patients come to the office thinking that it’s an enlargement of the bone or that excess bone has formed, when in reality the bunion is essentially a malalignment of the hallux metatarsal, the big toe metatarsal, projecting and making that inners side of the foot more prominent.

Typical treatment options focus on conservative measures initially, like wider toe box shoes, arch supports, anti-inflammatory medications, devices like toe spacers. They can be helpful earlier on but they really don’t correct the problem, and oftentimes as the bunion advances they don’t work at all.

My confidence in the Arthrex Minimally Invasive Bunionectomy procedure comes from the results that I’ve gotten over the past few years of doing the procedure. It has really been a game changer in my practice. It’s my workhorse procedure for bunion surgery, and it’s a procedure I really like doing because I know I can really help patients and make a big difference.

I haven’t looked back because most patients are doing exceptionally well.

* Physicians are paid researchers of Arthrex, Inc.
What are bunions and how are they formed?

A bunion may seem like a simple bump, but it is actually a very complex deformity of the foot. It begins when the big toe gradually rotates and leans in toward the second toe instead of being straight. The irregular angle of the bones is what you see as the bump on the inside of your foot. This shift in the bones can cause pain and altered weight bearing in the rest of the foot.

What causes bunions?

The factors that cause a bunion to develop on your big toe are unique for each individual. The most common causes of bunions are heredity and an imbalance in the foot structure. High heels that put your feet in an unnatural position and constrictive footwear that results in excessive pressure on your toes both may contribute to the development or progression of a bunion. Most likely, your bunion is the result a combination of conditions, both genetic and environmental.

What are the treatment options for a bunion?

Treatment options can be categorized as conservative or surgical. Conservative treatments include bunion pads or cushions, toe splints and spacers, footwear modification, shoe inserts, ice, and medication. These alternatives may alleviate pain in the short-term but are less effective in treating the deformity. Surgical treatment options, like the Arthrex Bunionectomy, provide a long-term solution by correcting the misalignment of the bones that caused the deformity.

When is surgical treatment of a bunion appropriate?

Surgical treatment is typically considered and may be necessary when persistent bunion pain limits overall functional well-being and your day-to-day activities. Surgery may relieve bunion pain through the realignment of the big toe. Ask your doctor if the Arthrex Minimally Invasive Bunionectomy is right for you.

Do all bunions require surgical treatment?

Bunions can be managed conservatively to reduce pain; however, the only way to properly correct the bunion deformity is surgically. Ultimately, increasing severity of symptoms (pain, loss of motion, aesthetics, etc.) is the motivation to consider surgical correction.

About the Procedure

Transcript
Noman A. Siddiqui, DPM, Discusses the Arthrex Minimally Invasive Bunionectomy

The goal of bunion surgery is very simple.

Most people think it’s just the “bump” that bothers you in shoes. That is a part of it—the shoe gear irritation is one component. But like a tire on a car that isn’t balanced, the goal of the bunion procedure is to realign the joint. Once the joint is realigned, the joint will function better, thus decreasing the likelihood of arthritis as we get older. Because like a car that’s malaligned, the longer you leave that car tire imbalanced the further it wears out.

This surgery is different because we are able to realign the joint, correct the position of the joint, and allow you to get back to walking sooner, which is a very important tenet of any surgery. We want to get good joint function, get you on your feet, minimize dissection, and most importantly get [the toe] moving faster so you can have better use of that joint.The Arthrex Minimally Invasive Bunionectomy has many benefits. I’ve said that, most commonly, my patients are recovering a lot faster. What that means is they’re using less narcotics, getting back into their shoes, and more importantly getting back to the life they were living either prior to this procedure or maybe long before, when they started getting bunion pain.

The Arthrex Minimally Invasive Bunionectomy utilizes specific instrumentation. We can do this procedure effectively, safely, and more importantly let them be home recovering very quickly.

* Physicians are paid researchers of Arthrex, Inc.
How does the Arthrex Bunionectomy differ from traditional open procedures?

The goal for any type of bunion surgery is the same: correct the alignment and improve pain and function. “Open” procedures access the area being treated through large incisions in the foot. While these large openings help the surgeon to see the bony structures, they may be accompanied by increased scarring as well as trauma to the surrounding soft tissues. This predisposes the joint to increased risk of arthritis and loss of motion after surgery. The same correction can be done through tiny poke hole incisions, guided by the advanced imaging technology used in the Arthrex Bunionectomy procedure.

How is the Arthrex Bunionectomy different from other procedures that claim to be “minimally invasive”?

The Arthrex Bunionectomy uses an entirely percutaneous approach. This means the surgery is performed through small poke holes in the skin, as opposed to the larger incisions found in open or fusion procedures. Fewer and smaller soft-tissue incisions also help to decrease the risk of infection and postoperative stiffness.  Arthrex’s minimally invasive approach reduces trauma to the surrounding tissues and uses minimal hardware to maintain correction compared to more invasive procedures. This allows for a generally faster and less painful recovery.¹𝄒²

Is the Arthrex Minimally Invasive Bunionectomy procedure as effective as “traditional” bunion repair since it is done through smaller incisions?

The Arthrex Minimally Invasive Bunionectomy involves the same bone realignment techniques as traditional bunion procedures, but the corrections are completed through smaller incisions. Similar results can be achieved through the minimally invasive approach of the Arthrex Bunionectomy.¹⁻³ The joint capsule and ligaments that hold the bones in place are left intact, which means less pain,¹𝄒² less swelling, and a faster recovery¹𝄒² for patients.

Can anyone with a bunion get the Arthrex Minimally Invasive Bunionectomy procedure?

The Arthrex Minimally Invasive Bunionectomy procedure allows your doctor to make a custom correction specific to the degree of your bunion deformity. Most bunion deformities can be surgically corrected with the Arthrex Minimally Invasive Bunionectomy procedure. Ultimately, your physician will determine whether you are an appropriate candidate for the procedure. Click Here to find a foot and ankle surgeon near you who uses the Arthrex Minimally Invasive Bunionectomy procedure.

Can any doctor perform the Arthrex Minimally Invasive Bunionectomy procedure?

Doctors found on the Find a Doctor feature have received training specifically on minimally invasive surgical techniques. Many of these doctors have attended an Arthrex Medical Education course specializing in minimally invasive surgical techniques and are well versed in the Arthrex Bunionectomy procedure.

Why do surgeons choose to perform the Arthrex Bunionectomy procedure on their bunion patients?

The Arthrex Minimally Invasive Bunionectomy allows full correction of the bunion while being done through several poke hole incisions that are about 1/8 of an inch in length as opposed to 3 or more inches for traditional surgeries. This permits an earlier return to weight bearing and daily activities, and generally much less pain postoperatively.

“My happiest patients are those that have had traditional open bunion surgery on one side and later have had the Arthrex Minimally Invasive Bunionectomy on the other side. They are able to compare the incredible benefits of Minimally Invasive Surgery firsthand” – Jorge I. Acevedo, MD.

The benefits and outcomes speak for themselves. Less postoperative pain,¹𝄒² quicker recovery time,¹𝄒² better range of motion,¹𝄒⁶ decreased anesthesia time, and small incisions² are all reasons to perform the Arthrex Bunionectomy. Most notably, improved patient experience and satisfaction are evident.

If I have had a previous bunion surgery, can I still qualify for the Arthrex Minimally Invasive Bunionectomy?

The Arthrex Minimally Invasive Bunionectomy may be a great option to correct a previous bunion surgery or to address a recurring bunion. The minimally invasive nature of the procedure allows surgeons to avoid previous incisions and the additional risk of wound problems. Minimal soft-tissue disruption also helps reduce any scar tissue formation from a previous surgery.  Less vascular disruption maintains good blood supply to the area, providing a good healing environment. Patients who faced complications from previous surgeries (loss of motion, arthritis, recurrence, or long postoperative period) may be good candidates for revision surgery using the Arthrex Minimally Invasive Bunionectomy procedure.

Can I have my hammertoe and/or bunionette deformities fixed at the same time? Do you use minimally invasive techniques for those procedures also?

Yes. Many bunion patients have other, often related, foot deformities that can be addressed during the same surgery. The same minimally invasive techniques can be used to correct bunionettes and hammertoes without adding much time to the actual procedure or increasing the recovery time.

Can I have both feet operated on at the same time?

Although technically safe to do both sides at the same time, it is generally recommended to have one foot operated on at a time for a better recovery process. Typically, surgery on the other foot should be scheduled at least 6 weeks after the first foot to allow time for healing. If you have extenuating circumstances that require a single surgical day, discuss them with your foot and ankle surgeon.

Is this procedure covered by insurance?

Yes, most insurance policies cover bunion correction procedures. Ask your doctor and insurance provider for specific details.

Do I qualify for the Arthrex Minimally Invasive Bunionectomy if I have diabetes?

For most surgeons, the Arthrex Minimally Invasive Bunionectomy can be performed on a well-controlled diabetic patient with properly managed blood-sugar levels. Please consult with your surgeon regarding your specific treatment plan as it relates to your health.

Recovery Information

Transcript
Christopher W. Hodgkins, MD, Discusses the Arthrex Minimally Invasive Bunionectomy

So following an Arthrex Minimally Invasive Bunionectomy, the recovery timeline is very quick.

Patients should expect to be in a surgical sandal, which is a stiff shoe, for 2 weeks after surgery. They can weight-bear on the heel during those 2 weeks. After two weeks, I will allow them to start walking on the front of the foot.

Because of the nature of the Arthrex Minimally Invasive Bunionectomy, they can start moving the toe very early, which avoids a lot of the stiffness associated with bunion surgery. And once they’re back in tennis shoes, it will allow them to slowly get back to regular activity and exercise whenever they're comfortable.

Following the Arthrex Minimally Invasive Bunionectomy, patients can expect to have almost no surgical incisions as a result of the minimal incisions and the quick surgery and the minimal surgical dissection, patients have much less pain after this surgery than they do with other traditional procedures.

Many of my patients don't need narcotics whatsoever, and they're able to just get by with over-the-counter medication, which is a huge advantage of this surgery, and that's a major advantage for me and a major advantage for my patients.

Pain management after an Arthrex Minimally Invasive Bunionectomy is so different than other traditional procedures out there.

I am very confident with your Arthrex Minimally Invasive Bunionectomy. I've done so many of these surgeries now that allow us to get patients back to work, back to regular shoes, back to high heels, back to exercise, much quicker than traditional procedures and other minimally invasive surgeries out there.

* Physicians are paid researchers of Arthrex, Inc.
What will my foot look like after surgery?

Immediately after surgery, an adhesive dressing and bandage wrap will be applied. Some surgeons will recommend a postoperative shoe or short boot. There may be some swelling. Soon after, when the protective wrap is removed, you will see a few stitches. Generally, the small incisions heal within a few weeks.  Most notably, following the Arthrex Bunionectomy, the bunion on your big toe will be gone and your toes will be properly aligned! Over time, your foot may appear narrower and you should be able to increase the variety of shoes you can wear comfortably.

Will I have a scar?

Several factors affect the degree of scarring including age, genetics, and skin color. Most patients can expect the three or four small incisions required to perform the Arthrex Bunionectomy to leave minimal scarring that will continue to fade over time.

How much pain will I feel after surgery?

There is some discomfort, but generally the pain is very manageable. The Arthrex Bunionectomy has been shown to have lower pain scores than historical open procedures due to the less traumatic nature of the minimally invasive approach. Other bunion procedures that fuse a joint require larger, more invasive incisions and disrupt soft tissues, leading to greater swelling and more postoperative pain. Depending on surgeon preference and patient needs, patients who undergo the Arthrex Minimally Invasive Bunionectomy can be prescribed pain medications or may choose to simply take over-the-counter solutions to help manage their pain.¹

Do I need physical therapy after my surgery?

Your surgeon can recommend an exercise plan to match your recovery needs. Many patients complete in-home therapy during the recovery from bunion surgery, while others may benefit from additional coaching provided by a physical therapist. A physical therapist can help ensure patients meet recovery milestones to meet timeline goals for returning to work or sport.

When can I return to sport or my daily activity level?

Gradual progression of activity typically occurs during the 2 to 6 weeks following surgery. Tolerable return to daily activities can be expected 3 to 4 weeks post-surgery, and return to high-impact exercise such as running 6 to 12 weeks after surgery. Your doctor will recommend a timeline specific to your needs and recovery process.

When can I drive after the procedure?

It is recommended you wait to drive until you progress out of a postoperative shoe or boot, typically 2 to 6 weeks after surgery. Your doctor will recommend a timeline specific to your needs and recovery process.

When can I get back to work after surgery?

It depends on your job. Patients who work desk jobs or from home can resume work within several days of surgery. Rest and elevation are recommended to help with pain control and swelling in the first few weeks. If your job requires standing or walking for long periods, it may take longer for you to return full-time.

Will I be able to wear the shoes I want after surgery?

After surgery, you may wear most shoes comfortably. Once any swelling has diminished, any desired shoes can be worn as tolerated.

Will I still be able to move my big toe?

Yes. The goal of the Arthrex Bunionectomy is correction of your bunion while maintaining motion of your toe. Other bunion procedures may limit this motion. Arthrex’s minimally invasive correction preserves motion with less postoperative stiffness compared to open or fusion procedures. Stretching and range-of-motion exercises may begin at the 4-week mark.

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Surgeons using the Arthrex Minimally Invasive Bunionectomy procedure have been trained in minimally invasive surgery for bunion correction.

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