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An update to my last post….

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An update to my last post…. i got a third opinion. To summarize if you didnt see my post. First doctor (podiatrist) said to do both feet within the next 3 years via lapiplasty. Second doctor (Orthopedic surgeon) said do neither foot and when & if left foot worsens to do anthrex minimally invasive and specified to not do lapiplasty or lapidus. Third doctor (podiatrist) who works at an orthopedic center said: He agreed that a lapiplasty or lapidus is a good recommendation if I feel significant pain. He urged me to not do it if pain is minor or for cosmetic reasons and noted that there is no rush to do it soon. He reported I would not be a good candidate for minimally invasive and did not recommend doing anything to my mild bunion on my right foot. I still feel on the fence about doing it personally just because my pain is manageable unless I’m working out a lot, or poor shoes or walking a lot. Seeing horror stories has brought on fear especially because i’ve never had any surgery. But many of you recommended to do it while young noting complications later in life/ more difficulty recovery as you get older. I am keeping that in mind. If I do a surgery, i believe I would go with the last doctor… he does not do lapiplasty but does lapidus. Are there any significant differences between lapiplasty and lapidus besides trademarked hardware/tools?

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Community comment#1

I also agree with your last doctor. Good luck to you.

Community comment#2

How old are you? I had arthrex on both at 54 yrs old. I am glad I did it. I e had bunions my whole life. They got worse in my mid 40’s. I’m glad I did them.

Community comment#3

I waited until 2 1/2 weeks ago at the age of 75 to do Lapiplasty and fusion of my second toe. My big toe caused a hammer toe on my second in the last year. You probably have time to wait, but if it progresses at all, I'd have the surgery to avoid this happening to you. Don't be frightened by all of the scary posts. Im already walking in a boot and will progress to a shoe in 2 weeks. It's an aggravating surgery, but not terrible. Being non weight bearing for two weeks was the worst part for me.

Community comment#4

I’m 65 and had a lapidus, second claw toe done plus plantar plate .i left mine for 13 years , my bunion wasn’t the cause of my pain but it was more so my second toe and plantar plate as my foot became very floppy and no structure .. I am now 8 months post op .

Community comment#5

Everyone is a candidate for MIS bunion surgery. It’s definitely the way to go as it’s a much easier recovery, smaller incisions, and less pain. I would bet the last surgeon isn’t MIS trained. Lapiplasty is just a trademarked Lapidus with a specific jig and hardware. Nothing special about it as many companies have similar products. No reason why Lapidus wouldn’t be a good alternative choice, but MIS is much easier to recover from. If you’re getting pain from activities you like to do, it’s worth doing soon when you have at least 3 months to get back to normal life without anything else getting in the way of recovery.

Community comment#6

I did mine at 71. I think keeping your Wright down firstly is more important than age providing you are fit enough to enjoy your life after surgery.. no point doing it if you are in a wheelchair is there? Your feet look a nice shape...going by the faint outline.. are they?

Community comment#7

Lapiplasty is the procedure to have. Problem with lapidus versus Lapiplasty is at Lapiplasty is a jig system, which is reproducible every single time versus lapis you’re actually guessing and how much to cut. Plus you can start immediately weight-bearing on a lapiplasty versus lapidus Actually you have metatarsus adductus and may need further correction. We are part of a MTA3D study and you should check it out online and can supplement some of your bill. Better to do it now than later. Also MIS Mills surgeons don’t actually take a course on how to learn it. They just take a burr and they figure it out. A lot of them will take a course, but there’s actually a course truly for those who wanna learn the Lapiplasty as I am an instructor. Sure MIS has now a new classification of lateral wall explosion, even though it is a small incision. Doesn’t mean a good surgery to choose to have

Community comment#8

I would get a few more opinions if I were you. Here’s why: As a newly divorced woman whose engineer husband knew how to fix anything, I knew nothing about how to get my dryer to vent to the outside of my new house instead of into the garage. I got five different bids and five different explanations about it. And five radically different suggested solutions! At that point, I felt like I was nearly an expert on everything I needed to know, and I was able to choose the solution and vendor that were best for me and my situation. And perhaps even more importantly, I was much more confident about knowing which ones were NOT for me. One of the vendors wanted to saw into my foundation to get to the other side of the house, which was WAY unnecessary and exorbitantly expensive. It’s impossible to do too much homework before your first foot surgery...

Community comment#9

This is only my opinion......As one who has been performing bunion surgery for 38 years, I would avoid MIS surgery. Fads come and go. MIS surgery was popular in the '80's and went away because of the complications. It is my personal opinion that only a Lapidus procedure properly done will correct your bunion permanently. I do Lapidus surgery frequently and was trained to do Lapiplasty at the Hospital for Special Surgery in NY but I avoid doing it. It uses a lot of hardware that stays in your foot which many times you can feel through the skin and it can be painful. Remember the KISS principle, Keep it Simple Stupid. 1 screw and one staple buried in the bone and you're done. And yes, you are in a boot, non-weight bearing for 6 weeks and walking in the boot for 2 weeks. The following picture represents a Lapidus, Lapiplasty and MIS in that order. Which would you want?

No photo description available.
Community comment#10

You and I have very similar bunions. I’m 59 now and was 54 when I went into a orth surgeon to get an opinion. He told me that I could wait but he agreed to do my surgery and then COVID hit so I never did it. It’s been about 3 years since I’ve been able to do lunges. I’ve learned how to live with my bunions. I am very athletic and as long as I have the best fitting shoes/sandals and avoid painful triggers, I’m fine. I’ve had many personal training clients and friends complain to me of pain and problems after their bunion surgeries and for me that would be unacceptable.

the one thing I learned about this is everyone’s bunion is different and that the foot has so many bones. Some need other bones cut, screws, etc…there is a Dr that posts comments in the group. He is pretty spot on with his opinions. The lapro is a huge surgery with many screws and bones affected.

in your 20’s is still young, if not in debilitating pain then no harm in waiting. Everyone is different but if I had surgery in my 50’s it would have been much easier than leaving it another 20 years, by then I had other health conditions. I wouldn’t rush in too early.

this happened to me as well, my second toe is a dislocated hammer toe, and my third toe is shifting underneath it. I’m 58 and having a Lapiplasty in 3 weeks. My bunion and hammer toe started developing in my late 20s early 30s, I honestly don’t remember.

moderate on left, mild on right. I am hypermobile and also have femoral anteverison so I put a lot of weight on the inner of my feet. That has been explained to me as a reason why MIS may not be as durable. Would you disagree? the second doctor disagreed when I asked him! I do wish I could do lunges, wear the shoes i want and not have to worry about walking when traveling… Thanks for your input.

Peter Walimire I’m sorry Peter, if you’re saying, EVERYONE is a candidate for MIS SURGERY, I would have to disagree with you. You have to treat the individual patient. You have to take into account. the bunion size, the hypermobility, The bone density, the great toe position, and the IM angle Etc. I don’t think one procedure is the best procedure for everyone. Every person is an individual and the procedure chosen has to be chosen, according to the patient’s deformity and needs.

EVERYONE is a candidate for MIS bunion surgery. The only surgeons who say this are those who don’t understand how to utilize the techniques properly, which means they have very little experience doing it. This includes revision surgery, failed Lapiplasty, big bunions, small bunions, arthritic joints. There are so many easier ways to recover than big open surgeries with prolonged non-weightbearing.

I absolutely disagree. If done properly the tarsometatarsal joint gets locked in a fixed/rigid position after a well performed MIS bunionectomy so hypermobility resolves. When you cut the bone distal, you can position it however you want to. Not so for a Lapidus.

EVERYONE is, minus people who are just not good surgical candidates for health reasons. And even in these cases, MIS under local anesthesia is the safer option.

you’re wrong and probably not trained on the latest MIS techniques. The picture you posted on MIS the other day is a 2nd generation MIS Arthrex procedure from 2019. We do it better now, with fewer complications, with locking the TMTJ, and with more accuracy than a Lapidus with half the recovery time for the patient. Many papers demonstrate equivalent long term data to Lapidus from recurrence rates to union rates, etc.

Peter Walimire I guess we just have to agree to disagree. There is no way that one procedure is right for everybody

your the second person online today to point out “metatarsus adducts” and now im even more confused why none of the three doctors mentioned it or correcting any other toes. I did look into the study unfortunately no one in florida.

Linda Wiesner Yes, It’s ridiculous how much we have to learn in a lifetime to avoid making wrong decisions. It’s worth it though & if we’re lucky we can help others by sharing the knowledge👍 When I was very young an older person said to me to try and share all of your knowledge. I thought that was great advice then but so much more so now.

Isn’t lapidus carried high risk of nonunion? This is the situation I’m dealing with now. Got second opinions from other doctors - they suggested another lapidus with more hardware. Does a failed lapidus can only be treated by another lapidus? Very likely results in another nonunion 🫣

Community comment#35

I think as far as research goes the best results with no recurrence is the lapidus  both of your bunions look pretty severe to me

Community comment#36

I’m still researching & fence sitting at 61 but the pain is pretty bad. Doing stretches etc regularly relieves it a little & you should start that if you haven’t already. I am concerned for you that you have pain in your 20s. While mine were burning somewhat as they grew more in my 40s, I didn’t have the pain in my 20s like you. From what I have researched, the earlier & the less you have to have done, the less you have to recover from and if you’re having pain now I hate to think what it will be like in another 20 years for you. For me, finding the surgeon that you feel in your gut you can truly trust is everything. One that doesn’t make you feel like you’re just another quick turnover & contributor to his holiday fund. One that you don’t make a regret of a lifetime decision with. If you’re still living at home and have support and not so many commitments like a family to care for, consider now as an easier option for getting it rectified once & for all. I wish I had. Good luck & keep us posted.

Community comment#37

Hello! Thanks for accepting me in the community. Has any body heard of Endolog? My orthopedic doctor suggested me this technique for bunion surgery

Community comment#38

Following

lunges are something i havent been able to do for 10 years and im in my 20s. Hurts my bunions way too much. But i’ve also learned to not push it and modify exercise

I am like you, 60 and on the fence. Just haven't found a surgeon who feels right in my gut. I would go anywhere in the country for the right person.

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