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Old 08-25-2009, 08:56 PM   #1
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Arrow Lapidus Q's seeking answers from those who have experienced procedure themselves

Hello,
I am a 27yr old male who is having the Lapidus procedure performed on my right foot by an orthopedic surgeon.
If you have had the procedure done, and would be kind enough to answer my questions, it would put my mind at rest.

My questions:

1) The Lapidus usually involves the arthodesis of the 1st metatarsal, and the shortening of the 2nd metatarsal (as the Dr. will have to do in my case). If you have had this done to you, how did it effect the weight bearing of your foot? Does any of your weight transfer to your 3rd metatarsal?

2) Generally speaking, how satisfied with the overall results of the surgery? Would you do it again if you had to?

3) Does your knee track different? Did it change your gait and biomechanics of your body negatively in a significant way?

4) Did you lose any mobility in your big toe?

5) Did it significantly shorten your first metatarsal?

6) Did it change your shoe size?

7) Are you more athletically capable after the surgery?

8) How long did it take you to recover so that you were able to walk again?

Please dont feel as though you have to answer all of them, but any questions answered helps, and if you have any extra thoughts/advice, feel free to lay it on me.

Thanks again, and I look forward to your posts.

 
Old 08-26-2009, 06:37 AM   #2
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Re: Lapidus Q's seeking answers from those who have experienced procedure themselves

Hi,
I had the Lapidus bunionectomy done on my left foot about 6 years ago and I would say that I'm satisfied with the results.
I had arthodesis performed on my first metetarsal along with the shaving down of the bone and a tendon transfer. It is kind of a long recovery but I would definitely do it again if I had to. Weight bearing has not changed at all and I walk the same. It took me about 3 to 4 months before I could wear a shoe and walk somewhat normal. Don't expect too much at first, it takes time to heal and for everything to start feeling normal again. I would say that my foot kept on improving over the following 2 years. I practice karate and have no pain so I guess I'm more athletically capable than before (mainly because my foot doesn't hurt). Good luck with the surgery.

 
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Old 08-26-2009, 05:15 PM   #3
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monster bunion HB User
Re: Lapidus Q's seeking answers from those who have experienced procedure themselves

Hello, and welcome to the boards. I am 51 yrs old, and have had the Lapidus procedure done on both feet. I had the right one done in June 2007 and the left one done Feb 2009. It is good you are thinking about all these questions related to your foot. To answer your questions,
1. The weight bearing of the foot is much better after surgery, as it puts
your weight equally balanced on all your toes instead of the big toe taking most of the weight. An arch is created by the procedure, raising the first ray of the foot, which balances your weight the way the foot was meant to be.
2. I am very satisfied with the results. The recovery is not easy by any means, but if you can't walk without pain before surgery, it is worth trying it.
Yes, I would do it all over again if I had to.
3. I don't notice my knee tracking differently. I think my biomechanics of walking and gaint were changed in a positive way.
4. There is stiffness in the big toe after surgery, which gets better with movement and with decrease in swelling that comes with the surgery. My big toes were bent inward 18 degrees so they didn't have much of a regular movement before surgery. After surgery, the big toes were in proper alignment with the rest of the foot and could move more freely.
5. The surgery did shorten the big toes, but not significantly, and if it meant that I could walk properly, I really was not too concerned about this before surgery.
6. If you have a bunion and it is shaved, it can change your shoe size in terms of width, but I was a 7 wide before surgery and the width was snug because of the bunion and after surgery, I still buy 7 wide and they fit comfortably now.
7. After having the two surgeries, I could run if I wanted to, but I really don't want to push it, I'm giving the feet time to heal.
8. My first surgery, the correction was more severe, so it took me about 11 months before I was able to walk comfortably. My second surgery, it took about 4 months before I was able to walk comfortably. Swelling can take up to a year, and this swelling contributes to the pain and prevents you from walking comfortably.
Whew, I hope I have answered your questions. You are much younger than I so you will probably heal faster. Feel free to ask anymore questions. Good luck!

 
Old 08-26-2009, 08:04 PM   #4
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Re: Lapidus Q's seeking answers from those who have experienced procedure themselves

Thank you both for your thorough answers -- it helps alot to have someone say that they have had positive results. I am seeing a good orthopedic surgeon, so Im confident that it has a high chance of turning out well. The reason I need this surgery in the first place is that its a salvage surgery for a botched bunionectomy from a few years ago. But Im most happy to go through the pain you both have described for a foot that works right.
Thanks again, and if anything else pops into your head, feel free to let me know!

 
Old 08-27-2009, 09:31 AM   #5
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summerluvr HB User
Re: Lapidus Q's seeking answers from those who have experienced procedure themselves

[QUOTE=swhazlow;4064862]Hello,
I am a 27yr old male who is having the Lapidus procedure performed on my right foot by an orthopedic surgeon.
If you have had the procedure done, and would be kind enough to answer my questions, it would put my mind at rest.

My questions:

1) The Lapidus usually involves the arthodesis of the 1st metatarsal, and the shortening of the 2nd metatarsal (as the Dr. will have to do in my case). If you have had this done to you, how did it effect the weight bearing of your foot? Does any of your weight transfer to your 3rd metatarsal?

2) Generally speaking, how satisfied with the overall results of the surgery? Would you do it again if you had to?

3) Does your knee track different? Did it change your gait and biomechanics of your body negatively in a significant way?

4) Did you lose any mobility in your big toe?

5) Did it significantly shorten your first metatarsal?

6) Did it change your shoe size?

7) Are you more athletically capable after the surgery?

8) How long did it take you to recover so that you were able to walk again?

Please dont feel as though you have to answer all of them, but any questions answered helps, and if you have any extra thoughts/advice, feel free to lay it on me.

Thanks again, and I look forward to your posts.[/QUOTE]


Ok lets see. I had this procedure 16 months ago. I consider myself fully healed, no pain, no swelling, normal shoes (even a low wedge heel!). Back to my normal life (a lot of cycling, some walking). I'm 31 years old, pretty healthy / fit. And, a quick healer according to my surgeon.

1) I don't really understand this. Sounds like different then what I had. I had tendon moved, then a procedure to shave the bump and move the joint at the big toe. THen I had the fusion up by the ankle of the metatarsal with three screw. Nothing was done to my second toe. My big toe is a little shorter but looks fine. My problem was hypermobile joints caused severe bunion. walking is the same as before, accept no pain!

2) yes very satisfied. I am having my second foot done, accept it is not so severe so I'm having a Chevron procedure. (way less intense a procedure)

3) knee is fine. I never had a knee problem

4) a little but my toe was hypermobile to begin with (what caused the bunion) so I think this a good thing

5) no. slightly shorter, but you hardly notice it.

6) no. same size, but shoes fit way better. can wear normal widths, and can wear things like flip flops, or shoes with toe loops, or regular width dress shoes without it being painful.

7) no. this is just a foot surgery, not a miracle operation. It took away my foot pain, but that is about it. Don't expect too much. The main reason to do this is to ease foot pain, which worked for me.

8) at least two months before "normal" shoes, and even then I wore crocs the rest of the summer because my foot was so swollen. It was swollen for at least 4 months.

 
Old 10-04-2010, 07:17 AM   #6
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Re: Lapidus Q's seeking answers from those who have experienced procedure themselves

I am a 55 year old female (former school teacher). I had the Lapidus procedure 3 1/2 weeks ago. I cannot be WB (weight bearing) for at least 3 more weeks. I have eight screws and a titanium plate. My surgery was aggressive.My words of advice are similar to those who posted above.

1. Make a chart that tracks the time you take your meds how much water (or other liquid) you drink. Take your meds faithfully and stay hydrated (this helps to avoid constipation). I drank 8 oz. every hour.

2. Ice your foot every thirty minutes (on then off) for the first three post-op days and keep it elevated. When it was time to go to sleep I put an ice pack that was no longer frozen (but was still cool) on my foot for the night. I kept two ice bags in the freezer to rotate.The Velcro tabs on the ice bags weren't big enough to go around my boot so I used a very long, slender scarf to tie the ice bag onto my foot.

3. I went to the classified ads and purchased a used "knee scooter." I am the fifth owner. I only used crutches once for 2 minutes. My knee scooter has been amazing. I also crawl down the stairs.

4. The moment the doctor tells you to start moving your toes and joints - DO IT! My "at home" physical therapy began last week. Even though it's painful, I must rotate my ankle, flex and extend my toes, etc. While your body heals it builds your new connective tissue with collagen (a protein ). You can make it a little more flexible by stretching and pulling it while it's being laid in the wound area. If you wait for 6-8 weeks it's more difficult to gain back your range of motion.

5. Because of Oxycodone I had very little pain in my foot. My pre-surgery condition was far more painful. This week the swelling has really gone down and my foot (not the toes or the ankle) is a light purple color. Already it looks fabulous! I have no bunnions and the shape looks like normal foot. Wahoo!

Good luck!

 
Old 10-05-2010, 08:58 PM   #7
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swhazlow HB User
Re: Lapidus Q's seeking answers from those who have experienced procedure themselves

Thank you for your reply Rockwood --

Your information is very helpful and thorough.

Would you be kind enough to answer me on some of my fears?

1) I am mainly concerned with complications -- what made you decide to have surgery?

2) How did you feel about your surgery and surgeon before you had everything done? Were you absolutely settled in your mind, or were there some fears in the back of your mind that you had to overcome? If so, how did you overcome them?

3) Do you think its better to wait until one cannot bear the pain anymore to have surgery, or do think its better to have it younger (I am 29, male)?

4) Did you have a Gastrocnemic Recession (lengthen the calve muscle)?

5) Did you have a lengthening Lapidus (I only ask because you had a plate put in which means you needed major stabilization) or a standard Lapidus (standard being shorten the 2nd metatarsal and fuse the 1st metatarsal at the cuniform)?

Those are all the questions I can think of now, they mostly have to do with fears...

But, the Dr. who would be doing the surgery is fantastic.

In any case, I would love to hear your thoughts

Regards

 
Old 10-06-2010, 08:23 AM   #8
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Re: Lapidus Q's seeking answers from those who have experienced procedure themselves

When I was 32 years old I went in for a consultation because my bunions were painful and it was difficult to find comfortable shoes. The doctor said he could help me and suggested that I have a bunionectomy (less aggressive than the lapidus). I declined.

I am very athletic and healthy and like to prioritize my healthcare by first going the wholistic route (herbs, appliances, physical therapy) then enlisting medications and finally defaulting to surgical procedure when all else fails.

Five years ago, because of foot pain, I got a consultation from both an orthopedic surgeon and a podiatrist to see about getting relief. I listened to their recommendations then went home and thought about it. I declined surgery.

Instead I purchased crocs (shoes), wide shoes, bought some orthotics and hoped the pain would go away. It did until this year.

My right foot began to hurt so much that I could no longer walk without pain. I had to stop my exercise program (walking, hiking and pilates). So I went back in to the Podiatrist. He gave specific explanations for the procedures, had a great office and staff, and good bedside manner. Two of my friends recommended him highly.

He pulled my x-ray from 5 years ago up on his computer screen as well as the recent view of my right foot. I could clearly see how far my metatarsals had moved in the last five years. It was astounding. My condition had clearly gotten worse.

The procedure he recommended now was far more agressive (lapidus). If I had opted for surgery earlier it would have been simpler.

Constant foot pain is the reason I chose surgery.

In retrospect, if a doctor had taken the time to explain how my foot problems would escalate with time, I would have chosen to have a procedure done earlier instead of waiting until the pain was unbarable later.

I had the standard lapidus procedure. The titanium plate in my foot spans the cuniform-metatarsal joint. I did not need the gastrocnemic recession.

Because of Oxycodone (thank God for that) I have had less foot pain since my surgery than I was experiencing BEFORE the procedure.

I had no complications. I did ask the anesthesiologist to give me anti-nausea meds for my stint in the recovery room. Also, I asked my doctor to prescribe promethazine (anti-nausea) to take 15 minutes before I took my Oxycodone. Fabulous!

Hope this helps! Good luck in your decision making.

Rockwood

 
Old 10-09-2010, 12:43 AM   #9
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swhazlow HB User
Re: Lapidus Q's seeking answers from those who have experienced procedure themselves

Rockwood,
Again, thank you for your thoughtful response.

Your reasoning for not having surgery earlier seems sound to me. Surgery is such a big choice that I cant treat it lightly, and I also shouldnt let my fears get in the way of doing what's best for my feet.
From what I have read on HealthBoards.com, the people who have had the Lapidus are happy with the results. I am only concerned about very poor results.
I think at this point I will go ahead with the surgery and trust God for the outcome.
Thank you very much for you responses. I hope that you heal up well, and are on your feet shortly! I will also consider your practical advice regarding post op self care.
Thanks again!

 
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