Revision Surgery: The Surgery Nobody Wants to Talk About!
May 14, 2018 10:26AM ● Published by Dia
By Dr. Paul Steinke, Foot and Ankle Associates of North Texas
Simply put, revision surgery means your first surgery failed to fix your problem, or worse, you now have more pain or deformity than you had before your procedure. Now you may need another surgery to correct what failed.
Most surgeons hate the thought of having to do revision surgery almost as much as their patients do! Some practices even have policies that turn these patients away. One of the most common phrases I hear from my patients who have had a bad outcome from a previous surgery is “My previous doctor said there was nothing more that could be done for me.” I can tell you that the vast majority of post-operative problems have a solution, be it conservative or surgical.
Unfortunately, complications in surgery do occur. Specialization in revision surgery has given me the unique opportunity to review medical records from previous physicians and talk with our patients about why they have ended up with a complication.
Here are some of the common causes of poor surgical outcomes in my experience:
· The patient just experienced a known complication of surgery. Every surgery has the risk of a complication; they can be temporary or permanent.
· Failure to properly administer or follow post-operative instructions. Either the surgeon does not provide adequate post-operative instructions, or the patient does not follow the instructions during recovery.
· Failure to identify problems early and treat aggressively. When deformities are corrected, they can sometimes show signs of recurrence in the recovery period. If the doctor identifies this early, treatments like physical therapy and splinting can stop the progression.
· Unhealthy patient. Patients with systemic conditions that inhibit healing, like Diabetes, are at greater risk of complication and strict glucose control is paramount to reduced risk. Smoking also slows healing due to its ability to limit healthy blood flow to feet and legs.
· Inadequate physical therapy. Many foot surgeries that correct deformities or repair sports injuries require therapy, whether at home or through a physical therapist or chiropractor. Some patients do not actively participate in the recommended therapy, and this can lead to stiffness, pain, and weakness that could have easily been avoided.
· Poor surgical technique. Unfortunately, surgeons can fail to follow appropriate surgical technique, pick the wrong procedure, or operate on a patient who is not a good surgical candidate.
You have a complication. Now what?
When coming to the doctor for a consultation, it is always important to bring the facts with you. Be honest with your doctor about your compliance with the prescribed treatment plan from the previous doctor. Did you follow all post-operative instructions? Did you smoke post-operatively? We don’t want to make the same mistakes twice! Be sure to bring any x-rays, MRI, or other images and office notes from your previous surgeon. Though you are not absolutely required to bring these items, it provides the new surgeon with invaluable information to aid in your possible revision surgery and recovery.
Your visit may include the following:
· Review of medical records and imaging tests
· Complete foot and ankle examination
· Repeat x-rays and possibly an in-office sonogram of the affected area
· Discussion of surgical procedures and treatments needed to repair the condition
· Instructions on length of recovery and instructions for after the surgery
· Realistic expectations for the final result upon completion of recovery period
As physicians we understand that appointing to see a new surgeon to discuss treatment can be a difficult step to take. By taking this step, however, you will gain important information and insight in ways we can possibly help to get you to a better functioning foot. Nothing is more satisfying as a revision surgeon than returning a patient to normal activity when they thought their condition was hopeless. If you have experienced a complication from a previous foot or ankle surgery, you do not have to live with the pain – give us a call at FAANT!
Foot and Ankle Associates of North Texas
2421 Ira E Woods Avenue Ste 100, Grapevine
816 Keller Parkway Suite 101, Keller
Dr. Paul Steinke talks about revision surgery