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Wednesday, April 27, 2022

Lapidus Procedure for Bunions: Normal Results (what are your odds) for the Consumer

Summary of Results:

Lapidus is a very common bunion surgery and the results of this study following patients for 2 years showed the odds. One of the differences from standard Lapidus procedures that this study tried to prove was that they could allow their patients to walk much quicker than standard 8-12 weeks of non-weight bearing, therefore walking in normal shoes on average 45 days post surgery!! This is huge!!
The results are pretty standard for operations at the foot:
1/117 early re-occurence of the bunion (typically want to get 15 years out of this procedure)
11/117 hardware was irritative (considered a complication)
5/117 other complication including 1 non-union
In total, 7/117 were re-operated on to fix issue within the first 2 years post Lapidus

If you match up the results I tell my patients before they get surgery, I think this study is slightly better.
I tell my patients, that 85% of them will be happy they had the bunion surgery (really good from our Podiatry perspective). Of that 85%, 50% of those patients will say excellent results and 35% will say good results from the surgery (good means that they are not perfect, but they are still happy that they went through it). The other 15% get fair to poor results (with this study around 10% which is close). 1-2% of patients are poor due to an infection, non-union, early bunion return, etc. 13% are fair due to some of the issues brought up (hardware irritation, pain more than they like, entrapped nerve, negative effect somewhere else, etc). Poor results tend to be re-operated on to fix what went wrong, and fair results about 50% have a re-operation (7% overall re-operation) and the same number just want to live with the issue. This 7% is almost exactly what the study showed for re-operartion 7/117 which is normal Podiatry surgery odds. So, in summary, I think this study showed that Lapidus patients (fusion across the metatarsal tarsal area) can walk earlier then the standard recommendation since the complication rate does not go above the standard 15% at all. 

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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.