CME OnDemand: 2022 AOFAS Annual Meeting-Comparative Study of Patients Treated with the Original Lapidus Procedure That Evolved with and without Fusion Between the First and Second Metatarsals

Comparative Study of Patients Treated with the Original Lapidus Procedure That Evolved with and without Fusion Between the First and Second Metatarsals

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The study compared the clinical, functional, and radiographic outcomes of patients who underwent the Original Lapidus procedure (OLP) with and without fusion between the first and second metatarsals. The aim was to determine if the presence or absence of fusion affected the results. <br /><br />A total of 29 patients (38 feet) were included in the study, with a mean follow-up of 18.03 months. The patients were divided into two groups: one with fusion between the first and second metatarsals and the other without fusion. <br /><br />The results showed that both groups had significant improvements in clinical and functional outcomes, as measured by the visual analogue scale for pain, American Orthopaedic Foot and Ankle Society (AOFAS) scale, Lower Extremity Functional Scale (LEFS), and SF-12 physical composite scale (PCS-12). However, the group with fusion had higher scores on the AOFAS scale compared to the group without fusion. <br /><br />Radiographic parameters, including bony and soft tissue forefoot widths, intermetatarsal angle, and hallux valgus angle, also showed significant improvements in both groups, with no significant differences between the two groups. This means that satisfactory radiographic correction can be achieved even without fusion between the first and second metatarsals. <br /><br />The study concluded that there was no difference in the correction of hallux valgus deformities between patients who had fusion and those who did not after the OLP. However, patients with fusion may have better postoperative function based on AOFAS scores.<br /><br />The authors suggest that further prospective and comparative studies with larger populations are needed to evaluate the effects of forefoot width changes on clinical and functional outcomes.

Asset Subtitle

Danilo Ryuko Nishikawa, MD, Fernando A. Duarte, MD, Bruno R. Miranda, MD, Guilherme H. Saito, MD, Alberto Mendes, MD, Marcelo P. Prado, MD, PhD

Keywords

clinical outcomes

functional outcomes

radiographic outcomes

Original Lapidus procedure

fusion

first metatarsal

second metatarsal

visual analogue scale

American Orthopaedic Foot and Ankle Society

Lower Extremity Functional Scale