From the Research
Yes, a metatarsocuneiform (MTC) joint fusion following a Lapidus procedure can sometimes take longer than a year to fully consolidate. While most patients achieve solid bone fusion within 3-6 months after surgery, delayed union or nonunion can occur in some cases, extending the healing time beyond 12 months, as seen in a study where nonunion of the first MTC joint occurred in 10.3% of patients 1. Factors that may contribute to prolonged healing include smoking, diabetes, poor blood supply, inadequate surgical fixation, premature weight-bearing, advanced age, osteoporosis, and certain medications like steroids or NSAIDs. Patients experiencing delayed healing might notice persistent pain at the fusion site, continued swelling, or instability when walking. Management of delayed healing may involve extended protected weight-bearing, bone stimulation devices, vitamin D and calcium supplementation, or in some cases, revision surgery. Regular follow-up with your surgeon is essential to monitor the healing process through X-rays and clinical examination, especially if healing appears to be taking longer than expected.
Some key points to consider in the management and outcome of Lapidus procedure include:
- The average postoperative hallux AOFAS score was 80.8, indicating a significant improvement in foot function and pain relief 1
- Nonunion of the first MTC joint can occur, but it may not always be symptomatic, as seen in a study where only 1 foot was symptomatic requiring revision 1
- Early weightbearing protocols have been shown to be effective in achieving union and improving outcomes, with a mean time to radiographic union of 65 days 2
- Innovative fixation techniques, such as locking plates, may help reduce the risk of nonunion, but further research is needed to confirm their long-term efficacy 3
Overall, while the Lapidus procedure can be an effective treatment for moderate to severe hallux valgus, careful patient selection, proper surgical technique, and regular follow-up are essential to minimize the risk of complications and ensure optimal outcomes. Regular monitoring and management of potential complications, such as delayed healing, are crucial to prevent long-term morbidity and mortality, and to improve quality of life.