Bunion Surgery – Minimally Invasive Chevron Procedure (MICA)

What are the goals and benefits of bunion surgery?

The MICA procedure is an innovative new option for those suffering from a bunion or hallux valgus. It is an effective way to permanently treat the pain, soreness, stiffness, and limited mobility caused by foot bunions. If you’re experiencing severe foot pain – even when wearing comfortable, supportive shoes – and the swelling and stiffness are affecting your daily activities, bunion surgery can provide relief. It can also prevent further damage to the joints and cartilage in your toe, which could eventually lead to arthritis. Some of the benefits of the MICA procedure over traditional bunion surgery is that it offers a quicker recovery as there is no need to wait for the bone to fuse, less pain as the incision is smaller, more mobility sooner, you will be up and around in half the time.

What is this procedure for and how will it alleviate my symptoms?

MICA stands for Minimally Invasive Chevron Akin. The MICA procedure is a much less invasive method of correcting bunions and hallux valgus (big toe turning outwards). Not all bunions cause pain, however the angulation of the big toe can also cause pressure on the second toe, which can also become deformed (called a hammer toe). In some cases, the first two toes will cross over, which can then cause a lot of pain in shoes.

What happens during surgery?

The first step is to have standing x-rays completed for both feet. This can be arranged by your family physician. Not all diagnostic facilities do standing x-rays, so make sure to ask before you go. Prepare your questions for the surgeon to answer during your consultation. Try and maintain as much range of motion in your great toe as possible. Your surgeon may suggest that you lose weight and initiate an exercise program to achieve the most successful recovery. Smoking can significantly affect the healing process. If you smoke, be sure to speak with your surgeon about it, as smoking can dangerously increase surgical risks and slow down the healing process.

How do I qualify for this procedure?

All patients are required to complete a Pre-Surgical Patient Questionnaire to provide us with your basic medical history. We also request your most recent x-rays and should these confirm you are a suitable patient for the procedure and our facility we will request a History and Physical Form be completed along with bloodwork and ECG via your family doctor. The decision whether or not to offer the MICA procedure is made by an experienced orthopaedic surgeon. Although there are non-surgical options to manage the symptoms, nothing other than surgery can correct a bunion once it has formed.

What is the average process like and how long will it take for me to return to my normal activities?

The goal of bunion correction surgery is to realign the bones, eliminate the bump and create a straight big toe. During the procedure the surgeon will make a small incision at the base of your big toe, then cut the bones using a small (2mm) drill under x-ray guidance. The next step is to realign the metatarsal bone, remove any excess tissue or bony growths, and re-align the bone using small specially designed screws for stabilization to ensure the bones remain in the corrected position whilst they heal. Your surgeon will close the incision and bandage your foot.

How should I prepare for my surgery?

As your procedure uses these specialty screws and you will be provided with a special protective cast boot you can immediately put gentle weight on the affected foot. While individual results may vary, you should be able to wear comfortable and supportive shoes within 4-6 weeks after your procedure. You will be provided with the specialty cast boot, post-op medication prescription, and a Cold Therapy Machine to aid in pain relief and to manage swelling while you heal. It is not uncommon to have swelling for 4-6 months’ post-surgery. You will be limited in movements for the first 2 weeks but most people with sedentary jobs can return after that. For active, physically demanding occupations, 6 weeks may be required. Driving will be limited until your surgeon advises it is safe to do so. Physiotherapy or Occupational Therapy after 6 weeks’ post-op may assist in your recovery by helping to restore a normal gait and, massage and mobilization of the joints to reduce swelling. Typically, No exercising until at least 2 months’ post-op and no impact exercise until 4 months’ post-op.