42 Year Old Woman with Hallux Valgus and knee pain: What's the efficacy for corrective procedure?

Disclaimer:-

This is a HIPAA de-identified open-online-patient-record, posted here March 2018 after collecting informed patient consent (form downloadable Click Here.

A 42 year old woman complaining of knee pains attributed to her hallux valgus [Figure 1] and suggested operation by the orthopedic surgeon. He has a flatfoot and he was told not to do high impact exercises lifelong. What is the evidence of efficacy of a corrective procedure that it will reduce her knee pains. 

Figure 1

Recent discussion on Tabula Rasa: 

Past discussion around this case: 

• Even left is not good..and hence the knee pain.

• Overall flatfoot and this is a causing misalignment..in fact he told for life don’t do high impact exercises..

• Procedure is said..not major..max 2 days hospitals Nd 6 weeks need to wear special high heels to recover

• Sounds like this..In an arthrodesis, your surgeon will replace the damaged joint with screws or metal plates to correct the deformity.

• He said he will put screws

• Yes perhaps the intervention may work but it would be difficult to say for sure as the evidence is sparse. I guess in standard procedures knowing the surgeon well may not change outcomes. https://www.ypo.education/orthopaedics/foot-ankle/bunion-surgery-t105/video/

• This may be a procedural video but not scientific evidence of outcomes? Ask him about the name of the procedure so that you can look it up with better precision rather than the current approximation

•  I checked my old X-ray done in 2011 and the angles have changed drastically for the left foot too

• Btw the label is wrong right 2 pics of right foot and leftmost is left foot

• What is the severity of your pain? How does it affect your day to day functioning?

• Not in the location..but more pain in knee and overall feet..! :(

• How can we be sure that tackling the current location in focus will resolve the problems in these distant locations. There is a possibility that it might but to go ahead with a procedure to see if it will work out for you may need further searching for similar patients who too had a problem similar to yours and what were their outcomes after similar procedures?

• I saw many YouTube videos yesterday on oration and Post operative and the need for the procedure...I’m not sure still if all my problems will be gone..but with minimal tear in artilage tissues of knee this can only aggravate problem..my knee X-ray if right says I’ve alignment issues..

• What you saw is mostly opinion but the science is still young and the role of a placebo effect in medicine is paramount

• Check this girls vlog https://youtu.be/UPrfk4AALyQ