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Lapiplasty® Publication Summaries
View the summaries of the key peer-reviewed literature supporting the Lapiplasty® Procedure.
One- and Two-Year Analysis of a Five-Year Prospective Multicenter Study Assessing Radiographic and Patient Reported Outcomes Following Triplanar First Tarsometatarsal Arthrodesis with Early Weightbearing for Symptomatic Hallux Valgus
Liu GT, et al. J Foot Ankle Surg. 2022. 61:1308-1316
Summary: This is the first published manuscript detailing an interim dataset from the Lapiplasty® ALIGN3D™ multicenter, prospective clinical study. The results of the study include data on 117 patients with at least 12 month and 40 patients with at least 24 month follow-up (of 173 total study patients) following the Lapiplasty® Procedure, showed:
- Early return to weight bearing in a walking boot at an average 7.8 days;
- Significant improvement in radiographic measures of 3-dimensional bunion correction from pre-surgery to 6 weeks and maintained at 12 months (n=108) and 24 months (n=38) post-surgery; with 1 recurrence reported at 12 months post-surgery (0.9% recurrence rate);
- Return to work within 4 weeks (25.2 days) and to full, unrestricted activity within 4 months post-surgery on average;
- Significant improvement in patient-reported pain reduction on the Visual Analog Scale (VAS) and quality of life measurements on the Manchester-Oxford Foot Questionnaire (MOxFQ) and Patient-Reported Outcomes Measurement Information Systems (PROMIS) scores at 12 months (n=112) through 24 months (n=40).
Multicenter Early Radiographic Outcomes of Triplanar Tarsometatarsal Arthrodesis With Early Weightbearing
Ray JJ, Koay J, Dayton PD, Hatch DJ, Smith B, Santrock RD
Foot Ankle Int. 2019 Aug;40(8):955-960.
Summary: Multicenter, retrospective study of 57 hallux valgus (62 feet) patients treated with the Lapiplasty® Procedure and early return to weight-bearing (average 10.9 days post-op). At average follow-up of 13.5 months, the results demonstrated that 96.8% of study patients maintained their 3-plane bunion correction (Intermetatarsal Angle, Hallux Valgus Angle, and Tibial Sesamoid Position), and only 1.6% experienced a symptomatic non-union complication.
Comparison of Radiographic Measurements Before and After Triplane Tarsometatarsal Arthrodesis for Hallux Valgus
Dayton P, Carvalho S, Egdorf R, Dayton M,
J Foot Ankle Surg. 2020, 59(2): 291-297
Summary: Retrospective study of radiographic outcomes from 108 patients (109 feet) that underwent triplane 1st TMT correction using biplanar plating and began weight-bearing as tolerated within the first week after surgery. At an average follow up of 17.4 months, the results demonstrated all patients achieved successful bony healing of the operative joint, with 99.1% of patients maintaining their 3-plane correction (0.9% recurrence rate) and no hardware failures reported.
What Do Patients Report Regarding Their Real-World Function Following Triplane Metatarsophalangeal Joint Arthrodesis for Hallux Valgus?
Dayton M , Dayton P, Togher CJ, Thompson JM.
J Foot Ankle Surg. 2023, 62(2):254-260.
Summary: Retrospective study of 60 patients and their reported real-world function after undergoing triplanar 1st MTP arthrodesis using Lapiplasty® biplanar plating. At an average follow up of 28.4 months, 95% of patients would recommend this surgery to a friend or family member, 93% believed the surgery was successful and would have it again, and 92% of patients said pain in their foot did not limit any of their activities. All patients that participated in sports before surgery resumed participation after with a trend toward increased sports activity.
A Systematic Approach to the Surgical Correction of Combined Hallux Valgus and Metatarsus Adductus Deformities
McAleer JP, Dayton P, DeCarbo WT, Hatch DJ, WB Smith, Ray JJ, Santrock RD.
J Foot Ankle Surg. 2021, 60(5):1048-1053.
Summary: Manuscript presents a systematic approach to corrective arthrodesis of the 2nd & 3rd tarsometatarsal (TMT) joints for angular correction of metatarsus adductus, in conjunction with instrumented triplanar 1st TMT arthrodesis for hallux valgus.
Utilization of the Modified Lapidus Procedure for Correction of Moderate to Severe Hallux Valgus Deformity With Increased Distal Metatarsal Articular Angle
Shah M, Stirling B, Jackson JB 3rd, Gonzalez T.
Foot Ankle Spec. 2022. Online ahead of print.
Summary: Retrospective study of radiographic outcomes from 85 patients (99 feet) that underwent triplane 1st TMT correction using the Lapiplasty® System. At an average follow up of 5.3 months, the results demonstrated a recurrence rate of 3.0% with significant correction of distal metatarsal articular angle, hallux valgus angle, and intermetatarsal angle.
Lapiplasty: Three-Dimensional First Tarsometatarsal Arthrodesis for Hallux Valgus
Easley, M.A. , Santrock RD
Operative techniques in foot and ankle surgery 3rd Edition. Copyright © 2022 Wolters Kluwer
Summary: This textbook provides a comprehensive, authoritative review of operative techniques in foot and ankle surgery (including the Lapiplasty® Procedure).
Analysis of Shortening and Elevation of the First Ray With Instrumented Triplane First Tarsometatarsal Arthrodesis.
Hatch D, Dayton P, DeCarbo W, McAleer J, Ray J, Santrock R, Smith B.
Foot & Ankle Orthopaedics 2020, 5(4): 1-8.
Summary: A prospective, multicenter study of 35 patients analyzing shortening and elevation of the first ray after instrumented triplane tarsometatarsal (TMT) fusion with the Lapiplasty® Procedure. At an average follow-up of 6-months, the results demonstrated a mean first ray shortening on sagittal and AP radiographs of 2.4 and 3.1mm, respectively. There was no increase in metatarsal elevation and no patients reported lesser metatarsal pain post-operatively.
Effect on Foot Width With Triplanar Tarsometatarsal Arthrodesis for Hallux Valgus
Vaida J, Ray J, Shackleford T, DeCarbo W, Hatch D, Dayton P, McAleer J, Smith B, Santrock R.
Foot & Ankle Orthopaedics 2020, 5(3): 1-5
Summary: Multicenter, retrospective study of 144 patients (148 feet) who underwent triplane 1st TMT correction using Biplanar™ Plating. All patients demonstrated a decrease in bony and soft tissue width after surgery. Bony width decreased by 10.4 mm (10.8%) postoperatively, whereas soft tissue width decreased 7.3 mm (6.8%) postoperatively after triplanar first TMT arthrodesis.
Progression of Healing on Serial Radiographs Following First Ray Arthrodesis in the Foot Using a Biplanar Plating Technique Without Compression
Dayton P, Santrock R, Kauwe M, Gansen G, Harper S, Cifaldi A, Egdorf R, Eisenschink JJ
J Foot Ankle Surg. 2019 May;58(3):427-433.
Summary: Multicenter, retrospective study of bone healing with accelerated weight-bearing protocol in patients undergoing TMT or MTP fusions with Lapiplasty® biplanar plating. 195 patients were included with mean follow up of 9.5 months. Patients were allowed to begin weight-bearing on the operative foot approximately at post-op day 5. 97.4% of patients demonstrated successful bony fusion and 98.9% maintained a stable joint position over the course of the study.
Triplane Hallux Abducto Valgus Classification
Hatch DJ, Santrock RD, Smith B, Dayton P, Weil L Jr.
J Foot Ankle Surg. 2018, 57:972–981.
Summary: Rather than the 2D hallux valgus classification systems traditionally referenced, this manuscript presents a novel 3-plane (3D) classification system for the evaluation and procedure selection for hallux valgus treatment.
Class 1 – No metatarsal rotation;
Class 2A – Metatarsal rotation without sesamoid subluxation;
Class 2B – Metatarsal rotation with sesamoid subluxation;
Class 3 – Metatarsus adductus bunion;
Class 4 – Degenerative (DJD) bunion.
Biomechanical Characteristics of Biplane Multiplanar Tension-Side Fixation for Lapidus Fusion
Dayton P, Hatch DJ, Santrock RD, Smith B
J Foot Ankle Surg. 2018, 57:766-770.
Summary: Biomechanical study comparing the Lapiplasty® Plantar Python® tension-side fixation construct to Lapiplasty® Biplanar™ Plating, demonstrating a 17% improvement in maximum load to failure and a 103% increase in the cycles to failure (simulating post-operative weight-bearing).
Evidence-Based Bunion Surgery: A Critical Examination of Current and Emerging Concepts and Techniques
Dayton, Paul D. (Ed.)
Springer International Publishing [Textbook]. 2018.
Summary: This textbook provides a critical examination of the traditions and techniques commonly taught for bunion surgery and contrasts them with new, evidence-based anatomic and surgical concepts (including the Lapiplasty® Procedure).
Hallux Valgus Deformity and Treatment. A Three-Dimensional Approach: Modified Technique for Lapidus Procedure
Santrock RD, Smith B
Foot Ankle Clin. 2018, 23:281-295.
Summary: Manuscript reviews the 3-plane hallux valgus classification system, the novel surgical steps of the Lapiplasty® Procedure, and the Lapiplasty® Biplanar™ plating biomechanical results, and presents clinical outcome data from a 49-patient multicenter study demonstrating 96% maintenance of 3-plane correction and 0% non-union rate at 4 months following an immediate weight-bearing protocol with the Lapiplasty® Procedure.
Understanding Frontal Plane Correction in Hallux Valgus Repair
Smith WB, Dayton P, Santrock RD, Hatch DJ
Clin Podiatr Med Surg. 2018, 35:27-36.
Summary: Manuscript challenges traditional two-dimensional (2D) evaluation and management of the hallux valgus deformity, presenting a 3-plane hallux valgus classification system and the detailed surgical technique steps of the novel Lapiplasty® Procedure for triplanar hallux valgus correction.
Comparison of Tibial Sesamoid Position on Anteroposterior and Axial Radiographs Before and After Triplane Tarsal Metatarsal Joint Arthrodesis
Dayton P, Feilmeier M
J Foot Ankle Surg. 2017, 56:1041-1046.
Summary: Clinical study of 21 feet at 5.2 month average follow-up demonstrating the ability of the Lapiplasty® Procedure to successfully correct the three-dimensional (3D) deformity (including metatarsal frontal-plane rotation) in 95.2% of cases, and also restore the intermetatarsal angle to 5.5°, hallux valgus angle to 7.3°, and tibial sesamoid position to 1.8°.
Multiplanar Alignment System to Guide Triplanar Correction of Hallux Valgus Deformity
Smith WB, Santrock RD, Hatch DJ, Dayton P
Techniques in Foot & Ankle Surgery. 2017, 16:175-82.
Summary: Manuscript presents a novel, instrumented approach to 3-plane (3D) Lapidus fusion (Lapiplasty® Procedure) for correction of the hallux valgus deformity, including indications/contraindications for 3-plane Lapidus arthrodesis, 3-plane x-ray views for preoperative planning, detailed surgical technique steps of the novel, instrumented Lapiplasty® Procedure, and potential complications.
Comparison of the Mechanical Characteristics of a Universal Small Biplane Plating Technique Without Compression Screw and Single Anatomic Plate with Compression Screw
Dayton P, Ferguson J, Hatch D, Santrock R, Scanlan S, Smith B
J Foot Ankle Surg. 2016, 55:567-71.
Summary: Biomechanical study comparing Lapiplasty® Biplanar™ Plating to a commonly-used anatomic plate and screw Lapidus fixation construct, demonstrating significant improvements in biomechanical performance under maximum load to failure and cyclic loading (simulating post-operative weight-bearing).