Unfortunately, bunion surgeries are not always successful. In the scientific literature on this subject, there are different types and severities of bunions; there are about 130 described ways to operate on a bunion. Usually, when there are this many options, it means that the best option has not been discovered. Historically, bunion surgeries have been painful and often fail.
A successful result from bunion surgery should mean that the patient is better and they have also increased their function. In addition, the patient should be able to wear the shoes they want to wear, such as high heels. A good bunion surgery will also allow the patient to walk relatively soon after the procedure and return to work quickly as well.
If you have had a surgery for a bunion and find that you still have pain, or that it has moved, you may benefit from what is called ‘revision’ surgery. Revision surgery simply means that the previous surgery is changed or revised.
The goal of a revision bunion surgery is to achieve the successful result described above. This type of surgery is complicated and requires a significant amount of training and experience to do well.
A patient’s radiographs and any other imaging must be analyzed and measured, and the foot anatomy and relationships between the various parts must be carefully examined. The foot doctor or surgeon should understand fully the patient’s activity levels and work description before planning the appropriate surgery.
Post-Surgery Transfer Metatarsalgia
Many patients have pain under the second and third toes at the ball of the foot after a bunion surgery. This pain is usually with activity and can be burning, aching or throbbing. Sometimes there is swelling there as well.
This type of pain is called ‘transfer metatarsalgia’; this basically means that the pain was simply moved from the bunion to the area under the ball of the foot; pain remains, even after surgery.
Many times this pain happens after bunion surgery because the bone for the great toe was shortened a little too much during the correction of the bunion. The shape of the foot is changed, and the patient’s weight moves over to the next toes during walking. The bones for the second and third toes were not designed for bearing so much of the body’s weight and they react with pain due to stretching out and compression of the tissues around these bones.
For this problem, a revision bunion surgery would create the normal balance in the foot again through a complex process of lengthening the appropriate bones.
Surgery should not be considered lightly.
However, if a patient has undergone surgery and feels that they still have too much pain, a consultation is in order to determine if revision surgery is necessary. There are surgical and non-surgical options available that can help to alleviate bunion pain, even if you have already had surgery.