OP, I hope you went to a surgically trained foot specialist. I assume you are talking about a podiatrist. I hope it was not a person who does minimal surgery or only forefoot surgery. I am a podiatrist as my day job. There are too many of us that would rather do custom orthotics (cash pay) than fix the problem. By no means is surgery always the answer, but it often is with severe arthritis. Anytime there is pain, instability or deformity an arthrodesis (fusion of the joints) can often fix the problem. Certain joints, (1st MPJ, ankle) can be replaced, but as a general rule, fuse it. No movement no pain. Feel free to PM me with questions and if I know anyone in your location I can give you some suggestions. Orthotics can only do so much, shoes can do only so much.