What is the Success Rate of Bunion Surgery? Results, Recurrence and Risks

Bunion surgery is successful for many appropriately selected patients, but no single percentage describes every result. Modern bunion surgery has generally predictable outcomes.

The success of the operation depends on many factors, but some of the basics are around patient selection and procedure selection. Mostly, if the correct patient for the correct deformity, taking the whole patient as a whole into account, is selected, then the outcomes are more promising and successful. Furthermore, in terms of success, one can measure reduction in pain, functional improvement, as well as cosmetic appearance, and by no means does one supersede the other.

Success is measured in all aspects of correcting these problems, including cosmesis, function, and pain resolution. It may be that it is important for patients to wear smart shoes, and a functional improvement in being able to wear those shoes comfortably is considered success. In many cases, the deformity is progressive, and stabilising the deformity and realigning the foot so that it does not cause further problems such as hammer toes and other foot problems is considered a successful outcome.

As Bunion surgeons, if we solely focus on radiographic outcomes, then looking at improvement in the intermetatarsal or the hallux valgus angle alone could fail, because you could have a clinically corrected deformity on radiographs but the patient’s pain has not been resolved, or they cannot wear the choice of shoes because there are elements of joint stiffness. There may be patient and surgeon factors involved in improving the overall success of the patient’s bunion operation.

Whilst radiological parameters need correcting, we need to take into account the patient’s functional requirements, the health of their bone and joints, as well as the degree of deformity they present with.

Why Bunion Surgery Success Rates Vary

The main variance is the type of technique used. Not all techniques are powerful enough to address more severe deformities, and if a deformity is not corrected fully, then the recurrence rates are higher. Furthermore, if they have pre-existing arthritis, they could develop post-operative stiffness.

Certain techniques have advantages; for example, minimally invasive techniques have less soft tissue trauma and reduced risk of joint stiffness, and therefore may be more favourable than open techniques, which produce a lot more scar tissue.

There may also be cosmetic benefits of performing minimal access or minimally invasive keyhole surgery techniques.

Also Check: Different types of Bunion Surgery

Bunion Surgery Procedure and Patient Selection

Therefore, procedure and patient selection is an important part of the process. If a patient is generally healthy, has good bone quality, and has good joint quality, then a bunion procedure that can address the intermetatarsal and hallux valgus angle will produce favourable outcomes.

Minimally invasive bunion surgery is able to correct a larger variance of deformities than traditional scarf and osteotomy techniques. It is also joint sparing, so it does not involve fusion of any of the joints, which typically is performed with Lapidus-type procedures.

The recovery process is a lot easier with keyhole bunion surgery in that it allows early mobilisation and weight bearing while the bone heals, and swelling may subside over four to six months. The patient remains mobile throughout the process. Whereas with a fusion procedure, a Lapidus procedure, there may be an extended period of non-weight bearing, which causes its own problems such as joint stiffness and soft tissue atrophy.

Can Bunions Come Back After Surgery?

The recurrence rate with keyhole bunion surgery is usually low at approximately two percent, but literature has reported anything from ten to thirty percent in the past. I believe that older techniques did not involve screw fixation. Furthermore, there is a limit to how much correction can be achieved, but more modern techniques have improved success rates. Bunion surgery performed in the right hands with an experienced surgeon would definitely have recurrence rates of less than five percent.

How To Improve the Chance of a Good Result

Having generally controlled health, good nutritional status, such as adequate vitamin D and calcium levels, helps. Furthermore, having a thorough evaluation clinically, in terms of range of motion, the type of foot, and hypermobility, as well as X-ray charting to ensure that the correct procedure is performed, the outcome should be favourable. In patients where there is suspicion of joint arthritis, an MRI would be prudent prior to performing bunion surgery. This will mitigate any risk of poor results.

Questions to Ask Before Choosing Bunion Surgery

It is important to have a realistic outlook on recovery. In particular, most patients are quite optimistic about their recovery. It is true that keyhole bunion surgery allows a quicker recovery than open surgery.

Patients should try non-surgical treatments first, especially in more mild deformities, such as orthotics, which reduce the risk of progression, and wider shoes. Surgery is the only way to correct the bunion deformity.

Patients should look at the surgeon’s experience, whether they perform a range of operations and not just one type of bunion operation. Experience with multiple procedures will ensure that your surgeon is versatile and ensures that the correct bunion operation is performed for you.

Currently, I perform minimally invasive bunion surgery for at least ninety percent of my patients. However, there are patients with instability or pre-existing arthritis of the joints that require a Lapidus fusion or a first MTPJ fusion. Otherwise, they would not do well with keyhole bunion surgery.

Also Check: Bunion Surgery Recovery Week by Week

Frequently asked questions