Who I chose Lapipasty: Superior Fixation: The procedure uses two small, anatomically-shaped titanium plates that secure the foundational joint in multiple planes, much more securely than the single plate or screws used in traditional Lapidus procedures. This provides immediate structural stability. Addressing the Root Cause: The Lapiplasty procedure corrects the entire metatarsal bone in three dimensions, returning it to its normal anatomical alignment, rather than just cutting and shifting the bone in two dimensions. This proper alignment, combined with stable fixation, creates a more stable overall structure. Stimulating Healing: Early, protected weight-bearing actually helps stimulate the bone healing process in the correct position, which is beneficial for recovery. Reduced Motion at Surgical Site: The secure, biplanar plating minimizes motion at the surgical site, which, in traditional methods, would compromise healing and require a longer non-weight bearing period in a cast. While patients can begin walking in a surgical boot within days to a couple of weeks, the bone and soft tissues still need several months to fully heal before returning to high-impact activities. The ability to bear weight early is a significant advantage in the recovery process, allowing for a quicker return to daily life activities compared to traditional surgery, which often requires 6-8 weeks of strict non-weight-bearing. I hope this helps
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Got two opinions on bunion surgery.
Got two opinions on bunion surgery. Both took x-rays. Orthopedic surgeon specializing in foot and ankle - recommended 1st MTP arthrodesis (fusion) - opinion being that my big toe only has 30% movement currently (although it seems like I am able to move it). With that procedure, they address the arthritis and will also fix bunion. My podiatrist recommended lapiplasty (he doesn’t seem to think there’s too much arthritis) and believes I do have movement currently and doesn’t think a fusion should be the “first course action.” But would have me sign a consent prior to lapiplasty in the event that during that lapiplasty surgery it makes sense to do the 1st MTP arthrodesis. I also have a hammer toe which both would correct.
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I would recommend obtaining a third opinion, as the two physicians you have consulted have proposed completely different approaches to correcting your deformity. I would also suggest reviewing before-and-after photographs so you can better manage your expectations regarding potential outcomes. You may find it helpful to visit my website, footfirst.com, which provides visual educational resources to help guide your treatment decisions.
One is fusing the midfoot and one is fusing the big toe joint. I would probably go with the podiatrist since they will keep the big toe motion if at all possible. It really does depend on what X-rays look like too though.
They're both fusion procedures.
I would go with podiatrist, at least he’s not jumping right to a fusion but can do it if necessary
What’s concerning is if you do a lapiplasty, if you later need big toe fusion you’d then have that entire section of your foot fused which isn’t recommended. I have a very small bunion on my right big toe but the arthritis in my big toe is a bigger issue. All four surgeons I consulted with said they wouldn’t recommend lapiplasty for me if my bunion got worse bc I may eventually need big toe fusion. But maybe there’s another reason the podiatrist thinks lapiplasty is appropriate? Like you are hyper mobile? Personally I would get a few more opinions. I wouldn’t be excited to get lapiplasty if I also have big toe arthritis. You can also ask about doing a cheilectomy with an osteotemy to address both the limited range of motion and the bunion without fusing any joints. If that doesn’t work then you could revisit a fusion approach
Yes . I’m trying to figure out next steps as far as another opinion. Another podiatrist or another ortho surgeon. It’s interesting. One recommendation is from a podiatrist and the other recommendation is from an ortho surgeon specializing in foot and ankle. I’m not sure if that has anything to do with the two different schools of thought.
Yes, I just reread what I stated and see I may not have been clear - I do realize they are both fusions. With lapiplasty I will have movement and the other, I will not.
That is not necessarily true. I had a lapidus and I have full movement in, and use, of my toe.
Is Lapidus different than lapiplasty? I’ll have to look it up.
Lapiplasty is a branded 3D procedure with specific hardware from the company. Believe surgeons are specifically trained in it. Lapidus from what Ive read used standard screws and are done by experienced surgeons. From what Ive read in reviews including doctors, there are pros and cons each direction and likely really depends on your situation and who the surgeon is. Have seen in comments some doctors recommend lapidus as not all are trained for lapiplasty. But also does not necessarily make lapiplasty inherently better. All so confusing.
both share the same base procedure but there are key differences. Type that into ChatGPT and ask for a chart displaying the differences, risks, and costs.
My podiatrist recommended the lapiplasty because my big toe currently has mobility and based on xray, didn’t think arthritis was an issue.
it’s odd that they have such different opinions. I would get a third opinion and ask for an MRI of the foot. Radiologist will determine on the report if there’s arthritis or not in the big toe.
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