Back in the 1970’s and 80’s the world of foot surgery was very different. As a general rule foot surgery was carried out by an orthopaedic surgeon, who did not necessarily specialise in foot surgery. Overall relatively little foot surgery was regularly undertaken.
Podiatrists, seeing patients with various common foot conditions, some of which, having had foot surgery with various degrees of success identified, that there may be a better way to help patients resolve their painful, activity reducing deformities.
Podiatrists have always had a deep understanding of foot function and pathology, and so adding on to these competencies with specialist surgical skills learned from Orthopaedic surgeons and North American podiatric surgeons. The development of podiatric surgery in the UK started to take place in the 1970’s after access to local anaesthetics was granted for Podiatrists.
Throughout the 1970’s and 80’s some pioneering UK podiatrists started to offer simple surgical procedures to private patients, these procedures were under local anaesthetic and not sufficiently major to require a hospital stay.
In the mid to late 1980’s these highly cost effective treatment alternatives came to the attention of the NHS, and consequently new surgical units within hospitals were developed. During this time the scope of surgery became wider, with treatments such as bunion correction and forefoot reconstruction becoming viable under new regional anaesthetic block techniques.
In the 1990’s GP fundholding initiatives embraced the economic benefits of elective day case surgery performed by Podiatrists. By this time audit and outcome measures were demonstrating very positive benefits to this approach.
Moving forward to today, Podiatric surgery is a mainstream service in the NHS and in the private sector. Also interesting is that over the same 40 year history, orthopaedic surgery has changed with increased specialisation of surgeons in particular areas of practice and the wide adoption of day case surgery using regional anaesthesia.