Frequently Asked Questions About Lapiplasty® 3D Bunion Correction

Why choose Dr. Paul Steinke for my surgery?

Dr. Steinke has been specially trained in Lapiplasty® 3D bunion correction surgical technique and has participated in the Lapiplasty® Masters event, something that is only offered to select surgeons proficient in this procedure.   Only surgeons specifically trained in this technique can perform this surgery.  Dr. Steinke is passionate about the life changing nature of this procedure.  Click the video link below to see Dr. Steinke perform this procedure.

https://www.youtube.com/watch?v=CLpEtmlpllM&list=PLA6huoeo9x5oy36NZXGh4Pzh1o-DaGxHi&index=35&t=0s

When can I return to exercise?

While recovery times vary depending on several factors, about two weeks you can begin to perform core and upper body exercises, but no pressure to foot during exercise.  At 6 weeks after surgery you will return to a shoe and can begin low impact exercise in pool, on a stationary bike, or rowing machine, obviously at a lower intensity then you may be used too. Even leg exercises like leg curls, extensions are allowed because they do not require weight bearing after 6 weeks.   Full return to impact exercise begins at 12 weeks after you have seen the surgeon for follow-up. 

If I have bunions on both feet, can I have both feet operated on the same day?

Most physicians, including myself, will not operate on both extremities at the same time. There are several very important reasons for this.

1) You need a good foot to stand on. Even though you’ll be walking in a walking boot, you will require the other foot for balance and transitioning during your recovery phase and if both feet are in a boot this is extremely difficult. This also increases fall risk.

2) Surgical procedures in extremities all come with some risk of developing blood clots, but with one sided surgery this is very low. With one boot in place, relatively normal walking is possible where with two boots it’s almost impossible.

3) With two walking boots in place after surgery, it is more difficult to reduce pressures to the affected feet when walking therefore you can prolong recovery or cause failed fusion of the site.

4) Patients may experience more pain after surgery if both limbs are operated on due to difficulty with elevation and walking.

Is Lapiplasty® 3D bunion correction covered by insurance?

Every painful foot condition should be covered by insurance, and Lapiplasty® has not been declined by any insurance in my practice to this date. 

I have a bunion on each foot, can I fix them at the same time?

While there are always some exceptions, generally this one is a no.  After surgery you will need your good foot to stand on.   Having both feet done at the same time, significantly reduces your movements, and patients who don’t move have an increased risk of complications. Usually, patients need to wait at least 6 weeks after the first bunion is corrected to have a second surgery.

I have other foot problems; can they be corrected during 3D bunion correction surgery?

Patients with bunions can often have condition like hammertoes, pinched nerves, and other conditions that may be responsible for causing the bunion itself.  Sometimes minor issues on the other foot can also be corrected on the same day.  No surgeon wants you to go through a surgery and recovery more than once, so in the vast majority of cases all problems will be fixed the same day, as long as they are on the same operative foot.   

Can I return to my normal activities I enjoyed before surgery?

The beauty of 3D bunion correction is that it allows patients to return to all their previous activities without any restrictions, even shoes like heels that traditionally were not recommended can be worn after surgery, in moderation of course.

If I have a failed previous bunion surgery, is 3D bunion correction an option for me?

As long as great toe joint arthritis is not significant, yes 3D bunion correction is a great option.  If great toe joint arthritis is present a different procedure called a great to joint fusion is needed, but even these patients too can return you to normal activities.

Is 3D bunion correction the only option for bunion repair?

3D bunion correction is merely the most recent advancement in bunion surgery, there are many ways to repair a bunion.  Your bunion can be corrected with a more historical approach, but risk of recurrence of deformity is increased with traditional approaches.   Depending on patient age, or patients health, other more classic approaches to repair your bunion may be recommended.

Can children with bunions have this procedure?

Yes, this procedure and its titanium plates are FDA cleared for use in children.  Patients must be of an appropriate age to proceed, once their growth plates in the affected bones have closed, at earliest usually 14 years old.

Can I have an allergic reaction to the implanted metal plates and screws?

3D bunion correction utilizes titanium plates and screws for bone repair. Titanium is the least reactive metal used in plates and screws because it does not contain high levels of nickel. Nickel is found in stainless steel, the other common implant material used in plates and screws. It is extraordinarily rare to have to remove titanium due to allergy.

Do I need physical therapy after this procedure?

Some patient do, most don’t.   If you can perform the following exercises in the link below you can do this at home.   If you can’t move your toe yourself comfortably, than PT is recommended, especially if you have had adjunctive procedures to other parts of the foot that are not related to bunion and require PT.  Click the video link below to see range of motion exercises after bunion surgery.

https://www.youtube.com/watch?v=WmeWscEMxBo

How old is too old for bunion surgery? 

Age does not necessarily matter, the health of the patient does.  This surgery can be successfully performed on patients into their seventies as long as they have good overall health, as well as good bone health.  Supplements to aid healing are often recommended for these patients.

If I have diabetes can I have 3D bunion correction?

Yes, as long as you are controlling your blood sugars, have a normal HbA1c test, do not have numbness in your feet, and are healthy overall.

Can I wear shoes like high heels and flip flops after surgery?

Yes, but moderation is key.

Is 3D bunion correction inpatient or outpatient surgery?

This procedure is an outpatient procedure in a surgery center that takes about an hour to complete.  More time can be needed if more additional surgeries are being performed. An anesthesiologist administers you anesthesia, and patients return home about an hour after surgery completion.  Most patients only spend about 3.5 to 4 hours at surgery center total on the day of their procedure.

Where and how long are the surgical incisions in 3D bunion correction?

This procedure requires an incision over the middle of the foot behind the great toe of about 4 cm or less when using the mini technique. Two smaller incisions will be needed, one at the great toe joint and one in the middle of the foot that allows the placement of a positioning clamp, all incisions being closed cosmetically for optimal healing and appearance.

Can I fly after having 3D bunion correction surgery?

For at least 4 weeks, flying is not recommended due to the fact that the foot cannot be elevated, the lack of movement while flying and the increased cabin pressure present on the plane.   All of these factor scan increase the risk of a usually rare complication called a blood clot. 

Can I return to work after 3D bunion correction surgery?

Well that depends.  If no restrictions are allowed and you have to be on your feet all day then 6-8 weeks is required.  If you can have restriction to sit during most of the day and not lift heavy objects, it is recommended to wait several weeks before return.   If absolutely necessary to get back to work, some patients return in 3-4 days, as long as their foot is elevated at all times, and they are icing frequently.  While most patients stop narcotic pain medication after 3-7 days after surgery, if you could continue to take these you should not return to work until you cease taking these medications.

How long will I need to take pain medication after 3D bunion correction surgery?

Most people discontinue narcotic pain medication 3-7 days after surgery.   Some take medication longer if needed when they go to sleep at night.   Patients are advised to transition to over the counter pain medication like Tylenol as soon as possible after surgery.  Click the video link below for post-operative pain control instructions

https://www.youtube.com/watch?v=1LWSwJYnVZs

Does 3D bunion correction come with increased cost to the patient?

No, 3D bunion correction comes with the same surgical cost to the patient as any other bunion corrected at the bunions source. Other bunion corrections that do not correct the bunion at its source and do not address metatarsal rotation can have different procedure cost.

How much pain will I have after Lapiplasty ® 3D bunion correction?

Most patients report 3 or 4/10 on the pain scale after surgery if they reduce activity, ice their foot, elevate and take pain medictions.  This varies by patient and if you have a history of a lot of pain after other surgeries, specialized pain blocks can be performed to keep foot numb for 3-4 days after surgery. This includes local anesthetic injections like Exparel, and regional blocks performed by your anesthesiologist.

Any unanswered questions?

Send any additional questions to 3dbuniondoc@gmail.com

Disclaimer: Any Replies from Dr. Steinke to your questions do not constitute a physician patient relationship