From the Research
It is not common to see a space at the fusion site one year after Lapidus surgery, as the fusion site should typically be completely healed with solid bone union by this time. The Lapidus procedure, which fuses the first metatarsocuneiform joint to correct hallux valgus (bunions), generally achieves complete fusion within 3-6 months post-surgery 1. If a gap or space is visible on imaging at the one-year mark, this may indicate nonunion or delayed union, which occurs in approximately 5-10% of cases 2.
Some key points to consider:
- The Lapidus procedure has a variable nonunion rate ranging between 4% and 10% 3.
- Risk factors for nonunion include smoking, diabetes, poor bone quality, inadequate fixation, or excessive early weight-bearing 2.
- Patients with persistent gaps may experience continued pain, instability, or hardware problems.
- Treatment options for nonunion might include bone stimulation, revision surgery with bone grafting, or different fixation methods depending on the specific situation and symptoms.
According to the most recent and highest quality study, the union rate of the modified Lapidus procedure is higher than previously reported when performed with rigid cross screw fixation, meticulous joint preparation, and shear-strain-relieved bone graft, with a union rate of 97.3% 1. If you're noticing a space at your fusion site one year post-surgery, you should consult with your foot and ankle surgeon promptly for evaluation, which may include weight-bearing X-rays or CT scans to assess the fusion status.