Podiatric services from our experienced Seattle podiatrist, Dr. John Hoy encompass everything you need in qualified, compassionate medical care. Dr. Hoy has been in practice since 2000, and performs a range of foot surgeries, from office surgeries to hospital surgeries. He works with each patient to find the most effective treatment plan for the individual condition. The best outcome is our first priority. A robust array of non-surgical options, such as extracorporeal shockwave therapy, orthotics and physical therapy, are used as first-line treatment to resolve your foot or ankle condition.
Sometimes foot and ankle conditions do not resolve with non-surgical care, may benefit from early surgical intervention, or require urgent surgery, such as in the case of infections and injuries. When pain or deformity persists, surgery may be appropriate to alleviate discomfort or to restore the function of your foot or ankle.
Dr. Hoy can determine when surgical intervention may be helpful. In addition to certification in non-surgical podiatry, Dr. Hoy is Board Certified in Foot Surgery by the American Board of Foot & Ankle Surgery (ABFAS).
The American Board of Foot and Ankle Surgery, the only certifying board for foot and ankle surgeons, requires completion of an approved surgical residency, and utilizes a demanding, comprehensive certification process encompasses passing written examinations, submitting simple and complex surgical cases and completing simulations of cases. This ensures diplomates perform a diverse and extensive range of foot and ankle surgeries and that they have demonstrated the highest level of proficiency to earn board certification. To demonstrate continued proficiency, foot and ankle surgeons must be re-certified every 10 years. Dr. Hoy is also a fellow of the corresponding American College of Foot and Ankle Surgeons, the recognized surgical specialists of podiatry.
“Dr. Hoy is extremely conscientious and provides many treatment options. My surgery ended up with increased range of motion and less pain in my foot.” -Debra
Surgery is only recommended and performed when it’s the best solution. Dr. Hoy cares that you have a good surgical result, and will only offer surgical options that would have a good chance of success. We will refer to other centers of excellence in the local area to extend the breadth of surgical options for procedures outside the doctor’s training and experience, such as reconstructive rearfoot or ankle surgery.
Types of Foot Surgery
Bunion Surgery: There are many different types of bunion surgery depending on the severity of the bunion and the joint involvement. Dr. Hoy can explain the bunion procedure that is most appropriate for your bunion. Depending on the surgical procedure, the recovery time can be very different—particularly if you need to be on crutches after the surgery or in a cast.
Fusions: Fusions are usually performed to treat arthritic or painful conditions of the foot and ankle. A fusion involves removing all cartilage from a joint and then joining two or more bones together so that they do not move. Fusions can be done with screws, plates, or pins, or a combination of these.
Hammer Toe Surgery: Hammer toe surgery may involve removing a portion of one of the bones in the toe to realign the toe or could involve fusing the joints in the toe (see Fusions, above). In some cases, it may involve placing a temporary wire to hold the toes straight or a permanent implant in the toe to maintain realignment.
Heel Spur Surgery: Based on the condition and the nature of the disease, heel surgery can provide relief of pain and restore mobility in many cases. The type of procedure is based on examination and usually consists of plantar fascia release, with or without heel spur excision. There have been various modifications and surgical enhancements regarding surgery of the heel. Dr. Hoy will determine which method is best suited for you.
Metatarsal Surgery: Surgery on the long bones of the feet behind the second, third, fourth, and fifth toes is performed for a variety of reasons but is commonly performed to redistribute the weight bearing on the ball of the foot. In some severe cases, such as rheumatoid arthritis, surgery may involve removing the metatarsal heads (the bones in the ball of the foot area).
Nail Surgery: Toenails can become deformed, damaged, or infected. It may be determined that the best treatment may involve surgery. Surgery is typically performed in the office under local anesthetic, and many patients can walk out and return to activities. Surgery involves either partial or total removal of the nail. An avulsion is a non-permanent type of surgery that allows relief, but the nail will grow back. A matrixectomy is a permanent type of surgery, which involves destroying and/or removing the nail root so that no new nail grows.
Neuroma Surgery: Neuroma surgery involves removing a benign enlargement of a nerve, which may be causing tingling/burning/numbness to certain toes, usually between the metatarsal heads in the ball of the foot. This soft tissue surgery tends to have a shorter recovery time than bone procedures, but it leaves some residual numbness related to the removal of the piece of nerve tissue.
Reconstructive Surgery: Reconstructive surgery of the foot and ankle consists of complex surgical repair(s) that may be necessary to regain function or stability, reduce pain, and/or prevent further deformity or disease. Unfortunately, there are many conditions or diseases that range from trauma to congenital defects that necessitate surgery of the foot and/or ankle. Reconstructive surgery in many of these cases may require any of the following: tendon repair/transfer, fusion of bone, joint implantation, bone grafting, skin or soft tissue repair, tumor excision, amputation, and/or the osteotomy of bone (cutting of bones in a precise fashion). Bone screws, pins, wires, staples, and other fixation devices (both internal and external), and casts may be utilized to stabilize and repair bone in reconstructive procedures.
Skin Surgery: Lipomas, fibromas, warts, moles, and rashes can occur on any part of the foot skin surface. Some of these conditions can be painful and impact function. In other cases, they can be questionable because they are new in appearance and a biopsy may be recommended. These skin conditions may or may not be painful. Depending on the size and depth of the condition, surgery may be performed in the office under local anesthesia or take place in the operating room.
Tendon Surgery: Surgery on the tendons can be performed for acute injuries such as ruptures and can also be performed for chronic conditions to lengthen or shorten the tendon, depending on the problem. In some cases, tendons may be re-routed to improve foot and ankle function.
A new patient visit is required to identify the condition and discuss all treatment options. If office surgery is indicated, informed consent is obtained along with a discussion of postoperative instructions. Elective procedures requiring anesthesia will be performed on the next visit.
“Please accept this late review of the surgery you performed on my feet. After several weeks of “testing” the results of your surgery, I am most delighted with the recovery I have made. Both feet have recovered and I am using them as if I never had any problems. Should I be asked for a recommendation I will enthusiastically recommend you, Dr. Hoy. I close this message with a warm greeting about your staff. They complement the professional work you perform by making me, as a patient, welcome and important. I close this note by saying Thank You Doctor for your superb medical support.” -Pi M
Dr. Hoy is on staff at Swedish Medical Center, Ballard campus, one of the finest hospitals in the Seattle metropolitan area, where he performs outpatient hospital surgery and treats patients in the inpatient hospital setting.
Full knowledge of your condition and options allows you to make an informed treatment decision. A new patient visit to identify the condition and discuss all treatment options. We will discuss goals and expectations, especially with severe deformities or end stage disease. If surgery is needed, Dr. Hoy will explain fully what is involved, risks and benefits as well as recovery. If hospital surgery is indicated, an overview of the surgery is discussed and x-rays taken if necessary. A formal surgery consult with signing of consent forms will be performed on the next visit. Dr. Hoy will then work with your primary care physician to make sure you are healthy enough for surgery. He will also prepare you for surgery perioperatively, guiding you through all your questions throughout the healing process to ensure the best outcome possible, to increase mobility and activities.
Preoperative Testing and Care
As with any type of surgical procedure, those undergoing foot or ankle surgery require specific tests or examinations before surgery to improve a successful surgical outcome. Prior to surgery, Dr. Hoy will review your medical history and medical conditions. Specific diseases, illnesses, allergies, and current medications need to be evaluated. Other tests that help evaluate your health status may be ordered, such as blood studies, urinalysis, EKG, X-rays, a blood flow study (to better evaluate the circulation of the foot and legs), and an examination of the structures of your feet while walking. A consultation with another medical specialist may be advised, depending on your test results or a specific medical condition.
The type of foot surgery performed determines the length and kind of after-care required to assure that your recovery from surgery is uneventful. The basics of all postoperative care involve to some degree each of the following: rest, ice, compression, and elevation. Bandages, splints, surgical shoes, casts, crutches, or canes may be necessary to improve and ensure a safe recovery after foot or ankle surgery. Dr. Hoy will also determine if and when you can bear weight on your foot after the operation. He wants you to have a satisfactory and speedy recovery, and this outcome can be achieved by carefully following the postoperative instructions that you have discussed prior to and immediately after surgery.
Understanding Your Foot or Ankle Surgery
Some of the most common in-hospital reconstructive surgeries Dr. Hoy performs are for the following conditions:
- Arthritis, such as hallux rigidus or limitus
- Tendon repair
- Plantar fasciitis
- Bone spurs
- Bone infections
- Foot fractures
- Soft tissue masses, deep
Some of the common surgeries Dr. Hoy performs includes:
- Bunion surgery/hallux valgus repair
- Hammertoe surgery
- Tendon surgery, including for tendon ruptures
- Hallux limitus/rigidus surgery
- Joint repair and fusions of foot joints to address arthritis
- Osteotomies, to improve alignment and prevent worsening deformities or arthritis
- Bone spur removal
- Metatarsal surgery
- Reconstructive surgery
- Neuroma excision surgery
- Pediatric surgery
- Trauma surgery, including foot fracture repair and dislocation repair
- Soft tissue mass excision
- Management of infection
“I have had 2 separate foot surgeries through Dr Hoy, and both times I felt very comfortable with the procedures Dr Hoy recommended. He is knowledgeable in is field, and takes time to listens to his patient’s concerns. I would highly recommend him for your foot needs!” -Mary T.