From the Guidelines
A bone stimulator is unlikely to significantly catalyze midfoot bone growth one year after a Lapidus surgery, as the bone healing process has likely already completed or reached a plateau. Bone stimulators, such as low intensity pulsed ultrasound (LIPUS), are most effective when used early in the healing process, typically within the first 3-6 months after surgery 1. The use of LIPUS for bone healing is supported by clinical practice guidelines, which recommend its use as an intervention to stimulate bone growth (osteogenesis) compared to standard care without ultrasound 1. However, one year post-Lapidus procedure, the effectiveness of a bone stimulator is limited, and results will be less predictable than with earlier intervention. Some key points to consider when evaluating the use of a bone stimulator at this late stage include:
- The bone healing process has likely already completed or reached a plateau
- Delayed union or nonunion of the midfoot bones may still benefit from a bone stimulator, but results will be less predictable
- Common bone stimulator devices include ultrasonic stimulators (like Exogen) used for 20 minutes daily or electrical stimulators worn for several hours daily
- These devices work by creating small electrical or ultrasonic fields that stimulate osteoblast activity and increase blood flow to the area Before pursuing this treatment, it is essential to consult with your foot surgeon to evaluate your specific situation through imaging studies to determine if a bone stimulator is appropriate for your case, as insurance coverage may also be limited for late intervention.
From the Research
Bone Stimulator Effectiveness
- The use of bone stimulators has been studied in various contexts, including their application in foot and ankle surgery 2.
- Research suggests that bone stimulators can aid in bone healing, particularly in high-risk populations or when complications arise 2, 3.
- However, the effectiveness of bone stimulators in specific procedures, such as the Lapidus surgery, is not extensively documented.
Lapidus Surgery and Bone Growth
- The Lapidus procedure is a surgical method used to correct moderate to severe hallux valgus deformity 4, 5.
- Studies have shown that the Lapidus procedure can result in excellent stable correction of the deformity, with minimal shortening of the first metatarsal 4.
- However, nonunion of the first metatarsocuneiform joint can occur, with reported rates ranging from 10.3% to lower rates when using specific surgical techniques 4, 5.
Bone Stimulator and Midfoot Bone Growth
- There is limited direct evidence on the use of bone stimulators to catalyze midfoot bone growth after Lapidus surgery.
- However, the general principles of bone stimulation suggest that it could potentially aid in bone healing and growth, even in the midfoot region 2, 3.
- Further research is needed to determine the effectiveness of bone stimulators in promoting midfoot bone growth after Lapidus surgery, particularly in the context of delayed union or nonunion 6.