Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Hills, MI. Last updated April 2026.
Medically Reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatrist, Balance Foot & Ankle Specialists, Michigan. Last updated April 2026.
Foot surgery is a significant decision — and patients who ask the right questions before surgery make better decisions, have more realistic expectations, and achieve better outcomes. Here are 10 questions every patient should ask before agreeing to a foot procedure, along with guidance on interpreting the answers.
1. What specifically is causing my pain, and is surgery the right treatment for it?
Understanding the specific diagnosis and why surgery is being recommended (rather than continued or alternative conservative care) is foundational. A credible surgeon can clearly articulate the diagnosis, why conservative treatment is insufficient, and what the surgical procedure specifically addresses.
2. Have I completed the appropriate trial of conservative care?
For elective foot surgeries (bunion correction, hammertoe, plantar fasciitis), accepted guidelines specify completing 3–6 months of appropriate conservative treatment before proceeding surgically. Appropriate treatment should include: custom orthotics (not just OTC insoles), proper footwear, targeted injections, and physical therapy for relevant conditions. Has each of these been genuinely tried?
3. What exactly will be done during the procedure?
Understand the specific surgical steps: what bones or soft tissues are cut, moved, removed, or fused. Understanding the anatomy of what will be altered helps set realistic expectations for both the recovery and the final result.
4. What are the realistic success rates for this procedure?
Request outcome data — either literature-based success rates for the procedure or the surgeon’s own outcomes data. “Success” should be defined: does it mean pain resolution? Radiographic correction? Return to specific activities? Understand what percentage of patients achieve each outcome.
5. What are the main risks and complications?
Every surgery has risks. For foot surgery: wound healing complications, infection, nerve injury, hardware failure, non-union (in fusion procedures), recurrence of deformity, and blood clots are among the relevant risks. Ask about the specific risk rates for the procedure being recommended.
6. How long will recovery take, realistically?
Get a week-by-week realistic estimate: when can you drive, return to work (sedentary vs. standing), wear normal shoes, and return to sport. Unrealistic recovery expectations are among the most common sources of patient dissatisfaction after foot surgery.
7. How many of these procedures have you performed?
Surgical volume correlates with outcomes for most foot procedures. A surgeon who performs 50+ bunion corrections per year has substantially more experience than one performing 5 per year. For newer procedures like Lapiplasty or total ankle replacement, ask specifically about the surgeon’s case volume with that specific procedure.
8. What happens if the surgery is not successful?
Understanding the revision options if the primary procedure does not achieve the desired outcome is important, particularly for complex reconstructive procedures. What are the fallback options?
9. Are there alternative procedures to the one you’re recommending?
For most foot conditions, multiple surgical approaches exist with different trade-offs. Understanding why the recommended approach was selected (versus alternatives) and what the specific advantages and disadvantages are helps make an informed decision.
10. What will my foot look and function like in 10–20 years?
For younger patients especially, understanding the long-term durability of the surgical correction is important. Will a bunion recur? Will a fused joint cause problems in adjacent joints? What monitoring is needed long-term?
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Clinical References
- Coughlin MJ, et al. Surgery of the Foot and Ankle, 9th ed. Elsevier, 2014.
- Pinzur MS, et al. Current practice of performing foot and ankle surgery. Foot & Ankle International, 2012;33(4):321-325.
- McDonald EL, et al. Patient education and shared decision-making in foot and ankle surgery. Foot & Ankle Specialist, 2019;12(5):464-470.
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Book Your AppointmentDr. Tom Biernacki, DPM is a double board-certified podiatrist and foot & ankle surgeon at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has reached over one million views.
- Plantar Fasciitis: Diagnosis and Conservative Management (PubMed)
- Plantar Fasciitis (APMA)
- Diagnosis and Treatment of Plantar Fasciitis (PubMed / AAFP)
- Heel Pain (APMA)