Connections: No delays to walking with new MIS bunion procedure | Winter 2022
Connections is a quarterly newsletter for primary care providers covering the latest developments and advances in medicine at OHSU. Learn about the many clinical, education and outreach resources available to you and your patients.
From OHSU Health Orthopedics and Rehabilitation
Bopha Chrea, M.D., is an orthopedic surgeon with fellowship-training in Foot and Ankle. Her clinical interests include minimally invasive surgical techniques, trauma and sports injuries. She sees patients at OHSU and Adventist Health Portland, an OHSU Health partner.
Convenient care close to home
Our three fellowship-trained Foot and Ankle surgeons provide care across the OHSU Health system. Our surgeons see patients at locations throughout the Portland metro, including OHSU and partners Adventist Health Portland and Hillsboro Medical Center.
For mobile and active people, being off their feet for two to six weeks is one of the biggest challenges of standard bunion surgery. With the minimally invasive techniques now available at OHSU Health, we can get those patients back up and going almost immediately.
Outpatient MIS osteotomies
Our patients who receive minimally invasive osteotomies are discharged the same day. Patients can walk as soon as swelling and pain subsides. They wear an orthopedic shoe initially. We change the dressing two weeks postop, and then follow the patient for any further needs. With minimally invasive techniques, the small burr holes minimize risks of infection, pain, wound complications and stiffness. Most health insurance carriers cover this procedure. We are excited to bring this highly subspecialized capability to Oregon.
When the MIS shoe fits
In selecting good candidates, our team triages referrals based on each patient’s presentation. General indications for bunion surgery include:
- Debilitating pain
- Pain despite modifications and exhausting alternatives
- Radiographic worsening
We can correct moderate-to-severe bunions with minimally invasive procedures. However, there are many parameters to consider and more than 100 approaches to bunion surgery. We select the most suitable option for the individual to get optimal results.
Minimally invasive techniques are the future in the Foot and Ankle discipline. The American Orthopedic Foot and Ankle Society dedicated a whole day of the 2020 conference to minimally invasive surgery techniques. We are now able to achieve the same results with small poke holes that previously required big dissections. Examples include:
- Early great toe arthritis (cheilectomy)
- Minimally invasive calcaneal osteotomies for flatfoot/cavus foot
- Exostosis resection
- Transfer metatarsalgia
When to refer
Please refer any patient with a clinical need for bunion removal.