by Kayla
(Abilene,TX USA)
When a bunionectomy goes bad
I am 26 years old. I had an Austin bunionectomy performed two years ago. As a complication of my surgery I experienced avascular necrosis. In the past three months I have achieved a pain level higher than I had before the bunionectomy. I trust my surgeon and I understand these things happen. He wants to do an joint replacement. I don't sleep at night from the pain (even with 200 mg of celebrex daily and Lortab 7.5 PRN). I am afraid to have the surgery to repair the joint that has visibly collapsed in some areas and is obviously arthritic. I was wondering if you had any information about the joint replacement. I am starting a nursing career in the OR and really need to be able to walk, and I am miserable, but there is not a lot of research on foot arthroplasty and I'm afraid. I would just like to know if you have any information on the joint replacement, or if you have had any experiences with this type of surgery. Thank you for your help.
Hi Kayla,
You are right; all surgery has risks and unfortunately you are experiencing a risk associated with osteotomies.
I would really need to see the x-ray, but before I would consent to an implant (the life expectancy of an implant in the first mpj is 10-15 years, so at your age you are looking at maybe 2-3 further surgeries down the road), I would talk to your doctor about a bone graft to replace the diseased bone and perhaps in conjunction with a bone stimulator.
Assuming you do not suffer from any metabolic disease, are not on long term cortisone or a heavy alcohol consumer, I think the bone graft and bone stimulator makes a lot more sense. I am basing all this on the probability that the articular cartilage of the first metatarsal head is intact.
Do not be afraid to get a second opinion.
Marc Mitnick DPM
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