I had bunion surgery on 12/15/06 by a podiatrist with A.A.C.F.A.S credentials.
3 screws were put in.

During the bunion surgery the dr found about 50% of the cartilage was damaged due to the pressure of the bunion over the years, and he also found arthritis.

This was never mentioned to me until an office visit approx 2 months later during Fed 2007.
During this office visit he mentioned the cartilage damage, the arthritis, and he basically stated due to the cartilage damage it was basically bone rubbing against bone.
He talked about doing joint replacement to repair the cartilage damage and the arthritis.
I asked him why the cartilage damage never showed up on any xrays that were taken?? According to him it wouldn't show up. He stated it might show up on an MRI, but probably wouldn't.

My question is: is a podiatrist qualified to do joint replacement??

He also doesn't like to leave the screws in..according to him, the screws create weak points??

This ia a great question. I had 2 podiatrists in the same office suggest two different procedures for my Hallux Rigidus. One wanted to do a chielectomy, the other a total joint replacement. I began to question their differences. I suspect one was older and lazy and really didn't want to do surgery anymore but was forced back into it because another Dr. left the practice. BTW, this practice is very well thought of in my area and has a very good reputation for doing good work. Go figure! So, I have decided to go to a Board Certified Orthopedic surgeon who specializes in foot and ankle surgery.

I also want to know more about these new implants. How long do they last, potential risks, etc. I am 65 so don't think I have to worry about the inplant's "length of service"...:) I just want to be pain free so I can continue walking more than 15 minutes and just maybe get out of sneakers once in a while....

Good luck in your decision.

Hi Piggygirl - I would love to know who your doctor is as I live in the same county as you but I don't think we can say that here. I had bunion surgery on Oct 18th by a podiatrist in West Nyack and he also told me I had a lot of arthritis. He did tell me prior to surgery that he couldn't tell the condition of the cartilage from the x-ray and would only know once he was in so I guess that part is true. My big toe is not as straight as I would like it but it is 100% better then it was. He said he couldn't get the joint over (towards the second toe) any more because of the joint for the second toe.

I really have no pain although when I walk barefoot I still walk kind of funny on the outside of my foot! I'm still glad I had it done. Not being able to wear heels is kind of a downer but I guess I will get used to that.

Keep us posted on what you decide to do although I know I wouldn't be ready to go back into surgery. I do have one "permanent" screw in the first metatarsul that had to be fused during surgery.

Mary:wave:

i think a podiatrist is qualified for a joint replacement. does that mean strictly an implant?

First I've heard of screws creating weak points. But if the bone fused OK, then there shouldn't be any problem taking them back out.

Yes, a good podiatrist is qualified to do joint replacements of the foot. As with anything, there are good podiatrists and bad podiatrists, good orthopedic surgeons and bad orthopedic surgeons. I wouldn't want a bad MD of any sort cutting on me!

The very first podiatrist I went to was bad, bad, bad! He had credentials behind his name too, but I would have lived with the pain before I let him anywhere close to me with a knife! He barely touched my foot, took one look at my shoes (which happened to be a pair I rarely wore) and said my tight shoes had pinched a nerve over my big toe joint and gave me a steroid pack. Yikes! Never went back to him. Instead, I got a 2nd opinion and a correct diagnosis.

Conversely...I first went to a renowned foot and ankle orthopedist. This guy is supposed to be the best in the area, very well trained and credentialed. Perhaps he was too well educated to take a bunionectomy seriously. He botched the job requiring me to have a second surgery this time with a well credentialed podiatrist.
So...I don't know what the criteria is for choosing a good doctor. Credentials are of course important, but no guarantee. I will say that the podiatrists communication skills far surpassed those of the orthopedist. So from now on, if I can't communicate with a doctor...he/she won't get my business. J.