Evaluating Lapiplasty Outcomes for Hallux Valgus: A Retrospective Study

T JimEnez, Y Daneshvar, J Chawla, U Syed, J Lucido, P Greenberg, R Delmonte, R Walls

Introduction: Hallux valgus (HV) is a common triplanar deformity of the metatarsophalangeal (MTP) joint, affecting over 20% of individuals aged 18 to 65 and more than 35% of those over 65.[1] Traditional treatments often rely on two-dimensional assessments, leading to high recurrence rates. [2-4] Recent advancements in imaging highlight the need to address HV’s three-dimensional complexity. The Lapiplasty procedure has emerged as a promising technique for correcting HV deformities in all three planes, potentially reducing recurrence and expediting recovery. This study evaluates the outcomes of the Lapiplasty procedure.

Methods: A retrospective review assessed outcomes of the Lapiplasty procedure performed between 2020 and 2024 at a single urban academic medical center. The study included a minimum follow-up of six months. Primary outcomes measured were changes in intermetatarsal angle (IMA), hallux valgus angle (HVA), and tibial sesamoid position (TSP). Secondary outcomes included union rates, complication rates, and postoperative weight-bearing status.

Results: Fifty patients met the inclusion criteria, with a mean age of 53.8 years and a mean BMI of 26.5. The cohort included 40 females and 10 males. The average follow-up was 19.3 months. Patients achieved full weight-bearing in a CAM boot at 3.7 weeks and transitioned to sneakers by 7.5 weeks. Radiological outcomes showed significant improvements: IMA decreased from 17.5 to 4.5 degrees, HVA improved from 34.9 to 9.2 degrees, and TSP decreased from 6.4 to 3.4. Complications were reported in 52% of patients, including hardware removal, paresthesia, and bony complications such as asymptomatic nonunion and hallux varus.

Discussion: The Lapiplasty procedure significantly improves radiological outcomes for HV deformity. While it shows robust correction, the high complication rate indicates areas for improvement. Further research with larger sample sizes and extended follow-up is needed to validate these findings and optimize treatment strategies.