Patient-Reported and Radiologic Outcomes With the Lapidus Procedure

Abstract

Background: This is a retrospective review of patients who have had a Lapidus procedure for hallux valgus deformity correction, performed by a single surgeon. Methods: The clinical records, operation notes and available weightbearing preoperative and postoperative radiographs of all patients who had a Lapidus procedure between February 2008 and July 2018 for hallux valgus deformity were reviewed. The preoperative and postoperative hallux valgus angle (HVA), intermetatarsal angle (IMA), and talometatarsal angle (TMT) on anteroposterior (AP) and lateral radiographs were recorded. The postoperative Foot and Ankle Ability Measure (FAAM) scores were obtained from phone interviews. Results: Two hundred thirteen Lapidus procedures were identified between February 2008 and July 2018 and included in the final analysis. The average preoperative and postoperative HVA was 36.3 and 18 degrees, respectively, with an average improvement of 18.3 degrees. The average TMT angles showed a preoperative and postoperative difference of 1.1 degrees on the AP radiograph and 2.4 degrees on the lateral. The average preoperative and postoperative IMA angles were 16.5 and 7.4 degrees, respectively, with an improvement of 9.1 degrees. There were 9 cases (4.2%) of nonunion confirmed on radiography, of which 3 cases (1.4%) had revision fixation with bone graft and went on to radiologic union. Final FAAM scores were available for 151 patients (70.9%). From this group, 74.8% (113/151) scored higher than 90%, 16.6% (25/151) scored between 70% and 90%, and 8.6% scored between 50% and 70%. The patient satisfaction rate was 92.9% overall. Conclusion: This single-surgeon retrospective review of a relatively large number of Lapidus procedures reports acceptable radiologic correction and patient satisfaction. Level of Evidence: Level IV, Large case series.