Pain and activity limitations are the main factors influencing patients to pursue bunion surgery.

A recent study published in the Journal of Foot and Ankle Surgery showed the primary concern in patients pursuing bunion surgery was pain and activity limitations. Understanding why our patients want to pursue surgical intervention for this deformity is paramount to understanding their desires and tempering their understandings of potential outcomes and goals.

Source: Albright et al. JFAS 2025.

Pain and activity limitations significantly influence both the decision to undergo hallux valgus (HV) surgery and postoperative outcomes. Many patients experience debilitating functional limitations due to HV, with pain relief and the ability to resume normal activities being key motivators for surgery. Surgeons should address patient expectations regarding pain management and activity resumption, as some expect complete pain relief while others may be satisfied with partial improvement. Studies show that a small percentage of patients experience persistent or new pain post-surgery, highlighting the need for realistic preoperative discussions.

Although cosmetic concerns are not the primary reason for HV surgery, they frequently arise as a secondary consideration. Patients often associate a “normal” foot appearance with the ability to wear desired footwear. This underscores the need for better patient education on realistic cosmetic outcomes, particularly regarding footwear options post-surgery.

Additionally, fear of worsening pain and deformity progression plays a role in surgical decision-making, despite guidelines from the American Academy of Orthopedic Surgeons (AAOS) stating that bunion surgery should not be performed solely to prevent progression. Recognizing and addressing these fears can lead to more empathetic and informed patient-provider discussions, potentially preventing unnecessary surgeries.

Lastly, clear, evidence-based postoperative education is essential to managing patient expectations. Many patients seek recovery information from external sources, indicating a need for improved communication and accessible educational materials to enhance satisfaction and perceived surgical success.

Patient expectations for hallux valgus surgery are driven by pain relief, activity restoration, and cosmetic concerns, highlighting the need for clear communication on surgical outcomes, recovery, and realistic postoperative results.

Citation: Patient expectations in hallux valgus surgery: A qualitative analysis Albright, Rachel H. et al. The Journal of Foot and Ankle Surgery, Volume 64, Issue 2, 120 – 125