Arthritis
Arthritis, inflammation to a joint, can affect any joint of the foot. This typically produces pain, swelling and warmth. It can eventually lead to destruction of the joint resulting in deformity, stiffness, decreased range of motion, and the inability to ambulate normally.
There are numerous forms of arthritis. The most common type in the foot is called osteoarthritis. Other forms include rheumatoid arthritis, psoriatic arthritis, reactive arthritis, septic arthritis, and gout to name a few.
Osteoarthritis is characterized by a destruction of cartilage within a joint. This typically stems from repetitive stress on a joint that is breaking down. It is a degenerative process and typically advances with age. Joint cartilage is the smooth, hard tissue that covers the end of the bones at the joint. This is essential for the normal function of a joint as it helps protect the bones during movement. When the cartilage is broken down, it can cause joint space narrowing, extra bone formation and cystic formation (pockets of fluid within the bone). When the bones are no longer covered by this smooth surface, mechanical rubbing will continue to precipitate inflammation and pain. Common reasons for development of osteoarthritis are trauma or underlying biomechanical abnormalities that precipitate increased strain on a joint.
Diagnosis typically starts with obtaining X-rays to evaluate the bony architecture of your feet. Advanced imaging studies such as CT or MRI are sometimes recommended after a thorough clinical evaluation is performed. Nonsurgical treatment is typically the first approach and can be effective to help relieve symptoms. As the arthritis continues to progress, surgery may become the recommended course of treatment. Come see our specialists today for proper evaluation and treatment.
Bunions
You are not alone if you are suffering from bunion pain! Bunions are a common foot disorder that can affect up to 20-30% of the general population. They are characterized by an abnormal bump on the side of the joint to the big toe that can frequently cause pain and irritation. As the deformity progress, patients will typically see their big toe start to drift and point towards their smaller toes. In turn, this continues to exacerbate the deformity and you may notice your big toe and second toe begins to cross over each other. The bump on the inside of the foot continues to enlarge and become more painful. Patients may notice redness, swelling, limited movement of the joint and an inability to wear certain shoes. It is important to understand that bunions are a progressive disorder, although it is difficult to predict the rate of progression.
Development of a bunion is multifactorial and not necessarily the same for each patient. It is generally understood that genetics play a role in most cases. Other causes may include arthritis, history of trauma, flat feet, and a tight Achilles tendon.
Our specialists are experts at evaluating and managing bunion disorders. Diagnosis typically starts by obtaining x-rays of your feet. A thorough clinical and biomechanical evaluation is then performed to assess the bunion and any accompanied deformity. Advanced imaging studies such as MRI or CT may be recommended to get a better appreciation of your underlying pathology. After a comprehensive assessment is obtained, our specialists will then devise a customized treatment regimen. Initial treatment may involve nonsurgical, conservative measures. If you have previously failed these measures or your deformity is already in advanced stages, surgical intervention may be discussed. It is important to consider the impact that this disorder if having on your quality of life and on your desired lifestyle.
Did you know that there are over a hundred different type of bunion procedures described? Rest assured, our foot and ankle specialists are experts at bunion reconstruction. We strongly believe that every patient is unique and that their recommended treatment should be unique as well. The goal of surgery is to restore the anatomic position of the big toe, remove the bump, reduce pain, and improve function. Historically, most surgeons would shave the bump, which would not address the underlying pathology. The most recent research and innovation has found that a focus on three-dimensional, triplanar correction was vital to a predictable and desirable long-term outcome. This is commonly accomplished with a bunionectomy (realignment, remove bone growths, and rebalancing of muscles, tendons, and ligaments), osteotomy (making a cut through the bone to realign the joint properly), arthrodesis (fusion of the bones comprising the joint such as a Lapidus or a first metatarsophalangeal joint fusion), or arthroplasty (removing the damaged joint and inserting a joint replacement).
Choosing an appropriate procedure to achieve a successful bunion correction is critical. These are complex deformities that require a skilled foot and ankle surgeon. Our expertise ranges from a minimally invasive approach to a traditional, fully open approach and everything in between. Your surgeon will consider all patient factors when recommending a procedure.
Many patients have misconceptions about the pain they may experience following a bunion procedure. It IS possible to have a pain-free bunion surgery! Be sure to talk to with our specialist about our unique post-operative pain protocol. Incorporating the latest recommendations from surgical and medical literature, our regimen aims to not only reduce post-operative pain but also supports the reduction of swelling while expediting patient’s recovery.
Our specialists will also discuss your recovery period and help you understand what expectations should be set. With any surgery, there are potential risks and complications to weigh. Our priority is your health and helping to educate you on all the pros and cons. We understand that this is a difficult decision, and we are here to help.