Minimally Invasive vs Open Lapidus Bunionectomy: 1-Year Patient-Reported Outcomes

Area of Science:

• Orthopedic surgery
• Foot and ankle reconstruction
• Surgical outcomes research

Background:

• Hallux valgus is a prevalent foot deformity requiring surgical correction.
• The modified Lapidus procedure is a common surgical solution in the U.S.
• Clinical differences between minimally invasive surgery (MIS) and open modified Lapidus are not well-established, especially regarding patient outcomes.

Purpose of the Study:

• To systematically compare patient-reported outcomes between MIS and open modified Lapidus procedures.
• To evaluate the effectiveness of both surgical techniques in correcting hallux valgus.
• To assess complication rates associated with each approach.

Main Methods:

• Retrospective review of 140 patients with moderate to severe hallux valgus (66 MIS, 74 open).
• Assessment of Patient-Reported Outcomes Measurement Information System (PROMIS) scores preoperatively and at 1-year postoperatively.
• Radiographic and weightbearing computed tomography (WBCT) analysis of foot alignment and deformity correction.

Main Results:

• Both MIS and open Lapidus groups reported significant improvements in PROMIS physical function, pain, and global health scores.
• No statistically significant differences in PROMIS scores were observed between the MIS and open groups.
• While both techniques achieved excellent correction, open surgery showed greater correction of HVA and IMA, whereas MIS demonstrated greater Meary angle correction.
• Complication rates (nonunion, recurrence, infection, hardware removal) did not differ significantly between the groups.

Conclusions:

• MIS and open modified Lapidus procedures yield comparable patient-reported outcomes at one year postoperatively.
• Foot and ankle surgeons can expect similar patient satisfaction and functional recovery regardless of the chosen surgical approach (MIS vs. open).
• Both techniques are effective in correcting hallux valgus, with technique-specific advantages in radiographic correction that do not translate to differing patient outcomes at one year.