Lapiplasty®: A Superior Option in Minimally Invasive Bunion Surgery

As a surgeon with years of experience in foot and ankle procedures, I’ve witnessed the evolution of bunion surgery. Over the past decade, the field has moved from traditional open procedures to more advanced minimally invasive surgery (MIS) techniques. Among the emerging treatments, Lapiplasty® has garnered significant attention as one of the most popular methods for bunion correction. When comparing this technique with other MIS bunion surgical options, it's crucial to explore the nuances, benefits, and considerations to understand why Lapiplasty stands out.

Understanding the Bunion and the Importance of Surgical Correction

A bunion, or hallux valgus, is a deformity of the big toe joint, where the great toe deviates towards the smaller toes, causing a bony bump at the base of the toe. Over time, bunions can lead to pain, instability, and difficulty in walking, which often requires surgical intervention. For years, traditional open surgery has been the gold standard. However, with the advent of minimally invasive surgery, surgeons now have new ways to treat bunions with smaller incisions, less trauma to surrounding tissues, and quicker recovery times.

Minimally Invasive Bunion Surgery: A Variety of Approaches

Minimally invasive bunion surgeries are now more widely available than ever. Surgeons can correct the deformity through smaller incisions, with the goal of reducing postoperative pain, scarring, and recovery time. Here, I’ll briefly compare a few popular MIS techniques, culminating in why Lapiplasty® is the most common technique utilized for my patients.

MIS approaches with AkIn osteotomies to images on top and bottom left.

1. Traditional MIS Bunionectomy
   This method typically involves the removal of the bony prominence caused by the bunion and realigning the bones of the toe. The procedure is done through small incisions, which reduces healing time and scarring. It’s important to note that while the deformity may be corrected, the underlying instability of the joint in the midfoot remains unaddressed. In fact, many patients see their bunion return after just a few years due to the failure to properly address the structural misalignment.

2. Akin Osteotomy
   Akin osteotomy is typically used in conjunction with other bunion procedures to correct the alignment of the big toe itself. It involves cutting the proximal phalanx (the bone at the base of the great toe) to realign the joint. Though minimally invasive, it is often used alongside other osteotomies of the metatarsal.   Unfortunately, like an osteotomy in isolation, it also doesn't address the full structural issues and can lead to recurrence if not combined with other procedures.

Lapiplasty®: A Comprehensive Solution

Unlike other MIS techniques, Lapiplasty® takes a more holistic approach to bunion correction by addressing the root cause of the deformity rather than just the symptoms. Lapiplasty involves the 3D correction of the bunion, realigning the first metatarsal in three planes – angular, rotational, and transverse – providing a permanent solution rather than just a temporary fix.

This technique involves the following key components:

• Three-dimensional correction: The Lapiplasty system allows for correction of the bunion at its source by addressing all three planes of deformity. This eliminates the need for additional procedures like osteotomies or joint fusions.

• Stabilization of the joint: Using titanium plating and screws, Lapiplasty secures the bones in place, minimizing the risk of recurrence. This fixation allows for weight-bearing earlier in the recovery process and contributes to greater stability.

• Minimal soft tissue disruption: Lapiplasty’s® approach is minimally invasive, requiring smaller incisions and causing less damage to the surrounding soft tissues, including muscles, tendons, and ligaments. This results in less postoperative pain and quicker recovery.

Why Lapiplasty® has become the number one 3D bunion correction technique in America.

While other MIS techniques provide benefits like smaller incisions and faster recovery times, Lapiplasty offers long-term, durable results that other procedures have not yet clinically proven with studies like Lapiplasty® has. By correcting the deformity in three dimensions and stabilizing the joint with titanium hardware, Lapiplasty® focuses on long term correction, clinically proven to prevent recurrence 97-99% of the time with one 13 month and 17 month study.

Advantages of Lapiplasty® over Other MIS Techniques:

• Long-term results: Unlike traditional bunionectomies or osteotomies, Lapiplasty’s® approach directly addresses the structural issues, leading to a significantly lower recurrence rate.

• Earlier weight-bearing: Thanks to the stabilization of the first metatarsal, patients can bear weight earlier in their recovery, reducing the risk of complications and shortening rehabilitation times.

Conclusion: A Superior Option for the Modern Patient

In conclusion, Lapiplasty® represents the gold standard in minimally invasive bunion surgery. Its comprehensive approach to the deformity – correcting it in three dimensions and stabilizing the joint with durable hardware – makes it an appealing option for patients seeking long-term, reliable results. While other MIS techniques offer benefits such as quicker recovery times and smaller incisions, they often fall short in addressing the underlying causes of bunion deformities, leading to higher recurrence rates.

As a surgeon committed to providing my patients with the best possible outcomes, I am confident that Lapiplasty® offers a superior solution for the majority of patients.  When comparing MIS options, it’s clear that Lapiplasty® offers unparalleled advantages in terms of both short-term recovery and long-term success.