Bunion surgery gone wrong: what happens when your bunion surgery fails?

Recurring Bunion

If the bunion returns after surgical correction, most often, the underlying problem wasn’t addressed in the initial surgery, and the deformity was never really corrected. This may be partly due to the surgeon choosing a procedure that was inadequate to correct the deformity. At Dr. Bob, we are one of the few clinics in the nation experienced with all 44 types of bunion surgery, which gives us the ability to truly customize each bunion surgery for each patient.

To correct a recurring bunion, the surgeon must surgically align the displaced foot bones into their proper position. Excessive motion in the foot bones causes the bones to spread apart and the bunion to redevelop. This can be resolved with an osteotomy (a bone cut) or fusion (bone mending).

Most often, we recommend a Lapiplasty (the next-generation lapidus bunionectomy) to correct a recurring bunion. Lapiplasty bunion correction is considered the Gold Standard for bunion surgery. For the right patient, this procedure has the highest success rates, with essentially a 0% chance of the bunion returning.

This procedure has the lowest risk of recurrence of the bunion because the Lapiplasty addresses the source of the bunion deformity: a lax/hypermobile joint between the first metatarsal and the cuneiform (the bone located at the base of the big toe). In many cases, patients are weight-bearing within a few days of their surgery instead of bearing no weight for 7 – 9 weeks, which comes with traditional bunion surgery.

Excessively Short Big Toe

Any bunion surgery that involves bone cutting or fusion will result in a shortening of the big toe, but the big toe should not shrink so much as to cause you pain or impact your foot’s ability to function.

Shortening becomes a problem when it affects the ball of the foot, the functioning of the big toe joint, or the relationship of the big toe joint to the rest of the foot.

To correct an excessively shortened toe, the surgeon will likely reverse the initial surgery and develop a personalized plan to regain length. This could involve:

• Special lengthening bone cuts
• Bone grafts
• Bone fusion, or
• Growing new bone tissue

New Structural Problems in the Big Toe (Hallux Varus)

The medical term for your big toe is “hallux.” Hallux Varus refers to a structural problem where the big toe drifts away from the lesser toes, which can be painful and make it nearly impossible to wear regular shoes.

Hallux Varus is caused by a muscular imbalance resulting from a failed bunion surgery. The big toe is pulled in the wrong direction, possibly due to any of these problems with the surgery:

• Too much bone was shaved away from the bunion.
• The sesamoid – a critically important but small foot bone – was removed.
• The ligaments were over-tightened.
• There was an overcorrection of the bunion

To correct Hallux Varus, the surgeon will undo the work that was done previously. In some cases, the big toe joint may need to be fused into place. Hallux Varus is better corrected sooner rather than later. Otherwise, secondary problems may develop in the joint.

Severe Stiffness in the Big Toe Joint

After bunion correction surgery, it’s common and perfectly normal to experience some joint stiffness. You can loosen the joint up by wiggling it – this is why at Dr. Bob, we’ve developed procedures that keep patients out of a cast.

However, if you’ve received bunion surgery and spent your recovery time in a cast and crutches, you might experience more stiffness than usual. Larger bunion corrections can also result in more stiffness in the big toe joint than in smaller ones.

Stiffness is caused by the formation of scar tissue (adhesions) in the big toe joint. This can usually be corrected non-invasively:

• We can break up the adhesions with steroid injections
• Manipulate the joint while it’s under anesthesia.

If these techniques fail, we can also perform an arthroscopy to surgically remove the adhesions. This type of foot surgery is minimally invasive, involving only small incisions and a tiny camera. A last resort option would be to surgically stretch the joint using an external fixator to pull the scar tissue apart.

Arthritis

Rarely, a failed bunion surgery can result in the rapid onset of late-stage arthritis in the big toe joint. Arthritis occurs when the cartilage that cushions and lubricates the joint degenerates. Arthritis is characterized by pain, swelling, clicking or grinding in the joint, and the formation of bone spurs.

The three most common causes of arthritis from a failed bunion surgery include:

• Improper positioning of the bone
• Infection
• Bone death

Correcting this issue may be as simple as removing the bone spurs. However, it may be necessary to surgically re-align the metatarsals or perform a fusion on the big toe joint.