Improved Outcomes for Arthrodesis

July 21, 2017

*Online Exclusive*

Track 2: Biomechanics/Sports Medicine
Thursday, July 27
10–11:30 a.m.
Tennessee D/E

A surgical technique used when performing a tarsal-metatarsal arthrodesis—Lapidus bunionectomy—can produce improved outcomes with a faster and easier recovery. The procedure will be explained during a Biomechanics/Sports Medicine presentation Thursday.

“When performing the procedure, one does not need to invade the tissues of the first metatarsal phalangeal joint to perform the McBride portion of the Lapidus,” said Lawrence A. DiDomenico, DPM, residency director at Northside Medical Center in Youngstown, OH. “It makes the procedure safer, it has better outcomes, and it removes a host of potential complications the surgeon always worries about when performing this the traditional way.”

Dr. DiDomenico will review the procedure during his presentation, “Quantitative Analysis of the Degree of Frontal Plane Rotation Required to Anatomically Align the First Metatarsal Phalangeal Joint During a Modified Tarsal-Metatarsal Arthrodesis Without Capsular Balancing.” He is the fellowship director of Ankle and Foot Care Centers, Kent State University College of Podiatric Medicine, and has used his Lapidus procedure techniques since the early 2000s.

“I can tell you it works if the doctor does it right. Technically, it is difficult, but it is rewarding,” he said. “It has many advantages.”

One advantage is reduced recovery time. Historically, patients wore a non-weight bearing cast for six to eight weeks, but following the use of this technique for the procedure, they can bear weight in a walking boot the same day as surgery.

“It is one less surgical site, so there is less chance of infection or nerve issues. It minimizes the possibility of developing hallux varus, neuritis, stiff joint, infected joints and tissues, scar tissue, over-correction, and under-correction,” Dr. Domenico said.

Because patients are able to be more active following surgery, they often have better range of motion at the joint and reduced post-operative edema. Being active also helps reduce the risk of deep vein thrombosis and pulmonary embolism.

“The patient does not need to go through as much physical therapy and rehab,” Dr. DiDomenico said. “There is lower morbidity, quicker recovery, better outcomes, less of a scar, better cosmesis, and less swelling.”

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