Incidence of Complications After Minimally Invasive Lapidus Surgery

Area of Science:

• Orthopedic Surgery
• Foot and Ankle Surgery
• Minimally Invasive Procedures

Background:

• The Lapidus procedure has been adapted for minimally invasive surgery (MIS) in the US.
• MIS techniques face challenges due to learning curves and limited long-term outcome data.
• Complication rates for the updated MIS Lapidus procedure remain unevaluated.

Purpose of the Study:

• To systematically review and determine the incidence of complications associated with the minimally invasive Lapidus procedure.
• To evaluate the safety and reproducibility of this MIS technique for tarsometatarsal fusion.

Main Methods:

• Systematic review of electronic databases and peer-reviewed literature adhering to PRISMA guidelines.
• Inclusion criteria: MIS Lapidus (tarsometatarsal fusion), use of fixation, minimum 6-month follow-up, reported complications.
• Exclusion criteria: Cadaveric studies, technique guides, non-English studies.

Main Results:

• Five studies with 162 feet met inclusion criteria.
• Overall complication incidence was 12.3% (20 of 162 feet).
• Most common complications: hardware pain (9), nonunion (5), deformity recurrence (3), neurovascular injury (3).

Conclusions:

• The minimally invasive Lapidus procedure is a safe and reproducible surgical option for first ray deformities requiring tarsometatarsal fusion.
• Complication incidence appears lower than reported for open surgical variations.
• Further research on long-term outcomes is warranted.