Step Wise Approach To Surgery

As orthopaedic surgeons, we try our utmost to avoid unnecessary operations. When we do decide to proceed with any treatment it is always done in a step wise manner. This involves undertaking the least invasive procedure in order to address the underlying problem.

The first step of treatment will begin with conservative non-operative management whenever possible.

Forms of non-operative management include:

  • Activity modification
  • Rest
  • NSAIDs
  • Orthotics
  • Physiotherapy
  • Referral to podiatry
  • Footwear modification
  • Walking aids
  • Weight loss
  • Immobilisation in a surgical boot or plaster
  • Time……

The next step after failure of these non-operative measures, minimally invasive procedures such as injections will be considered when appropriate, as the next line of treatment.

If this is unsuccessful, then surgery is considered. When planning surgery we try to balance utilising treatments with good results yet have minimal complications and recovery time.

In the uncommon scenario that the first operation has not alleviated symptoms sufficiently, further surgery can be considered. The next procedure usually has a very high success rate but carries with it a much longer recovery time. This is often why patients do not choose to undergo this operation in the first place.