Arthrex Surgeons Walk Through the Arthrex Minimally Invasive Bunionectomy

Bunions are a very common foot condition. In fact, studies estimate that anywhere from one-fifth¹ to one-half² of adults suffer from them.

To help treat those bunions that require surgical correction, hundreds of procedures³ have been developed to address the bony deformity that creates that characteristic bunion bump on the side of your foot.

Traditionally, bunion surgery required doctors to create a large incision on the foot, which can lead to postoperative pain, swelling, and wound complications.¹

More recent technological advancements have led to minimally invasive surgical (or MIS) approaches to correcting bunions, like the Arthrex Minimally Invasive Bunionectomy. This procedure requires only tiny “pinhole” incisions to achieve triplanar (3D) correction without fusing a joint or using excessive hardware. Triplanar correction means that the surgeon rotates your toe so that it is correctly aligned, reducing the bunion bump.

There are other benefits to MIS bunion surgery compared to traditional surgery, including:

• Potential for immediate weight bearing after surgery^4,5
• Less postoperative pain, swelling, and stiffness^6-9
• Preservation of the movement of your toe^7,9

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Surgeons Share Their Approaches to the Arthrex Bunionectomy

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Like with any surgical procedure, surgeons must learn and become familiar with minimally invasive bunion correction and the special instrumentation required to perform the Arthrex Minimally Invasive Bunionectomy.

Additionally, like with any new skill, they become more effective and comfortable with the bunionectomy procedure as they perform it more.

Here, two surgeons who serve as Arthrex faculty at courses teaching other surgeons the Arthrex Minimally Invasive Bunionectomy—Noman A. Siddiqui, DPM (Baltimore, MD), and Andrew R. Hsu, MD (Orange, CA)—walk through the procedure’s steps and what they have learned from years of offering it to their patients.

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Step One: Preparing the Patient

The Arthrex Minimally Invasive Bunionectomy is typically an outpatient procedure that can be performed in a freestanding facility, such as an ambulatory surgical center (ASC), or in a hospital.

After positioning the patient to ensure the most access to the foot that will be operated on, it is valuable to use special visualization equipment, such as fluoroscopy or x-ray,^1,4 Drs. Hsu and Siddiqui wrote in their recently published articles.

This helps the surgeon “see inside” the toe, which allows for precise correction of the bones that have rotated out of alignment and are causing the bunion.

Step Two: Creating an Incision and Fixating the Bones

The Arthrex Minimally Invasive Bunionectomy requires just a tiny incision, through which specially designed instruments are used to perform the procedure.

First, the surgeon cuts through the bone of the toe closest to the rest of the foot. This is called an osteotomy. Next, they use a shifting device to move the toe into the correct orientation, which reduces the bony deformity. A guidewire is placed so that the toe stays in place during the rest of the procedure.

Then, the bones are permanently held in place with a fixation device. Drs. Hsu and Siddiqui write that they both use two low-profile screws, rather than other types of hardware, to fix the bones in the correct place.^1,4

These screws do not need to be removed, unlike earlier, traditional types of surgery that could require a second procedure to remove the fixation device.

After the screws are placed, the surgeon shaves down any part of the bone that may still be sticking out; this step helps reduce the potential for irritation of the skin above the bone.

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Why They Perform the Arthrex Minimally Invasive Bunionectomy

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In their papers, both Dr. Siddiqui and Dr. Hsu outline why they choose to offer this procedure rather than others available for bunion correction.

A major benefit is that patients can bear weight and return to activity faster, they write.^1,4 Depending on their recovery and comfort level, Dr. Siddiqui and Dr. Hsu transition most of their patients from a flat postoperative shoe into regular sneakers at 2 to 4 weeks, depending on swelling.^1,4 This is “significantly faster” than traditional procedures, Dr. Hsu says.¹

Most of their patients are able to return to full activity, including high-impact activities, 10 to 12 weeks after surgery.^1,4

“These benefits can lead to increased patient satisfaction and excellent outcomes,” Dr. Siddiqui writes.⁴

Learn more about Arthrex bunion correction at OrthoPedia Patient.

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Arthrex World-Class Medical Education for Surgeons

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Surgeons who want to offer the Arthrex Minimally Invasive Bunionectomy in their practices attend an intensive course taught by foot and ankle surgeons—who are already well-versed in the procedure—and Arthrex orthopedic medical educators. During the course, they learn practical tips through hands-on lab and training sessions focused on the specialized equipment used in the Arthrex Bunionectomy.

Not just limited to bunions, Arthrex is a leader in global medical education with a focus on minimally invasive, motion preserving procedures.

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References

1. Haghverdian J, Hsu A. Surgical tips, tricks for performing minimally invasive bunion surgery. Orthopedics Today. Published June 22, 2023. Accessed October 23, 2023. https://www.healio.com/news/orthopedics/20230616/surgical-tips-tricks-for-performing-minimallyinvasive-bunion-surgery
2. Ferrari J. Bunions. BMJ Clin Evid. 2009;2009:1112.
3. Jeuken RM, Schotanus MG, Kort NP, Deenik A, Jong B, Hendrickx RP. Long-term follow-up of a randomized controlled trial comparing scarf to chevron osteotomy in hallux valgus correction. Foot Ankle Int. 2016;37(7):687-695. doi:10.1177/1071100716639574
4. Thomas MA, Ravine M, Siddiqui NA. Siddiqui’s tips, tricks, and pearls for minimally invasive bunionectomy. Podiatry Today. Published December 2022. Accessed April 18, 2024. https://www.hmpgloballearningnetwork.com/site/podiatry/case-study/pearls-minimallyinvasive-bunionectomy-one-surgeons-decade-experience‍
5. Acevedo JI, Cedeno AA, Doty J, McWilliam J. Minimally invasive techniques for hallux valgus correction. Tech Foot & Ankle. 2022;21(1); 9-19.
6. Lee M, Walsh J, Smith MM, Ling J, Wines A, Lam P. Hallux valgus correction comparing percutaneous chevron/Akin (PECA) and open scarf/Akin osteotomies. Foot Ankle Int. 2017;38(8):838-846. doi:10.1177/1071100717704941
7. Lai MC, Rikhraj IS, Woo YL, Yeo W, Ng YCS, Koo K. Clinical and radiological outcomes comparing percutaneous chevron-Akin osteotomies vs open scarf-Akin osteotomies for hallux valgus.  Foot Ankle Int. 2018;39(3):311-317. doi:10.1177/1071100717745282
8. Kheir E, Borse V, Sharpe J, Lavalette D, Farndon M. Medial displacement calcaneal osteotomy using minimally invasive technique. Foot Ankle Int. 2015;36(3):248-252.doi:10.1177/1071100714557154
9. Frigg A, Zaugg S, Maquieira G, Pellegrino A. Stiffness and range of motion after minimally invasive chevron-Akin and open scarf-Akin procedures. Foot Ankle Int. 2019;40(5):515-525.doi:10.1177/1071100718818