Is it safe to run with a stable and asymptomatic nonunion of a Lapidus (tarso-metatarsal joint) arthrodesis in the midfoot?

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Last updated: April 6, 2025View editorial policy

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From the Research

Running with a stable and asymptomatic nonunion lapidus midfoot fusion is generally not recommended, even if you're not experiencing pain, as it may worsen the nonunion or lead to pain and complications. The lapidus procedure fuses the first metatarsal to the medial cuneiform bone, and a nonunion means these bones haven't properly fused together as intended [ 1 ]. Even if stable, this area remains vulnerable to the repetitive high-impact forces of running, which can exceed 2-3 times your body weight with each step.

Key Considerations

  • The risk of nonunion after Lapidus arthrodesis has been reported to be around 8.3% [ 2 ].
  • Factors such as previous bunionectomy, increased body mass index, and preoperative HV angle can increase the odds of nonunion [ 1 ].
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) may also increase the risk of nonunion, delayed union, or both following arthrodesis procedures in adults [ 3 ].

Recommendations

  • Lower-impact activities like swimming, cycling, or using an elliptical machine would be safer alternatives to maintain cardiovascular fitness.
  • Before attempting any running, you should consult with your foot surgeon or orthopedic specialist for a thorough evaluation, which may include imaging to assess the current state of the nonunion [ 4 ].
  • They might recommend specific supportive footwear, custom orthotics, or possibly revision surgery if running is an important goal for you.

References

Research

Identifying Risk Factors for Nonunion of the Modified Lapidus Procedure for the Correction of Hallux Valgus.

The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons, 2022

Research

The incidence of nonunion after Lapidus arthrodesis using staple fixation.

The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons, 2014

Research

Revision of Malaligned Lapidus and Nonunited Lapidus.

Clinics in podiatric medicine and surgery, 2020

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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