A review of surgical outcomes of the Lapidus procedure for treatment of hallux abductovalgus and degenerative joint disease of the first MCJ

BackgroundThe modified Lapidus procedure has been used to treat hallux abducto valgus and degenerative joint disease of the first metatarsocuneiform joint for many years. Historically, the Lapidus has been associated with poor satisfaction due to complications such as non-union. The aim of this study was to review the surgical outcomes of 18 patients using the validated Foot Health Status Questionnaire (FHSQ). The four domains within the FHSQ were all investigated. Pre and post operative angular measurements were also reviewed.ResultsThe results of the FHSQ were positive for all four domains, with foot pain having the greatest change. Only two complications were recorded: one poor pain control and one post operative bleed and all 18 patients went to osseous union. Radiographically the mean intermetatarsal angle improved by 7.8° and HAV angle by 22.9. A positive association was also demonstrated between validated ‘Minimal Important Difference’ (MID) scores.ConclusionThe Lapidus is a valuable procedure that can have few complications and high levels of patient satisfaction.