Journal article
Early results and complication rate of the LapiCotton procedure in the treatment of medial longitudinal arch collapse: a prospective cohort study
Archives of orthopaedic and trauma surgery, Vol.143(5), pp.2283-2295
05/2023
DOI: 10.1007/s00402-022-04399-0
PMCID: PMC10110656
PMID: 35312845
Abstract
Instability/collapse of the medial column has been associated with many conditions, particularly progressive collapsing foot deformity (PCFD), hallux valgus (HV), and midfoot arthritis (MA). Restoration of first ray length and sagittal plane alignment to restore the foot tripod is essential when treating these deformities. This study aimed to assess early results, healing, and complication rate of a distraction dorsal opening plantarflexion wedge allograft first tarsometatarsal joint fusion (LapiCotton Procedure) in patients with collapse/instability of the medial column.
In this prospective cohort study, we included PCFD, HV, and MA patients that underwent a LapiCotton procedure. Fusion site healing was defined by > 50% bone bridging in both interfaces between allograft wedge and host bone using weight-bearing computed tomography (WBCT) after 3 months. First ray collapse radiographic correction and minor and major complications (deep dehiscence, deep infection, and reoperation) were assessed.
A total of 22 patients (22 feet) were included (11 PCFD, 6 MA, and 5 of HV patients). Mean follow-up was 5.9 months (range 3-12) and median allograft size was 8 mm (range 5-19 mm). Bone healing was observed in 91% of cases. Two minor complications (9%, both superficial dehiscence) and one major complication (4.5%, deep infection) were observed. Statistically significant improvement of the sagittal plane talus-first metatarsal angle was observed, with mean improvement of 9.4° (95% CI 6.7-12.1°; p < 0.0001).
In this prospective cohort study of 22 patients treated with the LapiCotton procedure for medial longitudinal arch collapse/instability, we observed a low complication rate (9% minor, 4.5% major), high healing rate after 3 months (91%), one clinically stable radiographic non-union (4.5%) and one unstable non-union (4.5%) needing reoperation. Our results demonstrate promising initial results for LapiCotton technique in treating collapse of the medial longitudinal arch in patients with PCFD, MA and HV deformities. Long-term results are needed to confirm these promising results.
Level II, prospective cohort study.
Details
- Title: Subtitle
- Early results and complication rate of the LapiCotton procedure in the treatment of medial longitudinal arch collapse: a prospective cohort study
- Creators
- Cesar de Cesar Netto - Roy J. and Lucille A. Carver College of MedicineAmanda Ehret - Roy J. and Lucille A. Carver College of MedicineJennifer Walt - Roy J. and Lucille A. Carver College of MedicineRogerio Marcio Kajimura Chinelati - Roy J. and Lucille A. Carver College of MedicineKevin Dibbern - Department of Orthopedics and Rehabilitation, Carver College of Medicine, University of Iowa (UIOWA), 200 Hawkins Drive, Iowa City, IA, 52242, USAKepler Alencar Mendes de Carvalho - Roy J. and Lucille A. Carver College of MedicineTutku Erim Tazegul - University of IowaMatthieu Lalevee - Roy J. and Lucille A. Carver College of MedicineNacime Salomão Barbachan Mansur - Roy J. and Lucille A. Carver College of Medicine
- Resource Type
- Journal article
- Publication Details
- Archives of orthopaedic and trauma surgery, Vol.143(5), pp.2283-2295
- DOI
- 10.1007/s00402-022-04399-0
- PMID
- 35312845
- PMCID
- PMC10110656
- NLM abbreviation
- Arch Orthop Trauma Surg
- ISSN
- 0936-8051
- eISSN
- 1434-3916
- Language
- English
- Electronic publication date
- 03/21/2022
- Date published
- 05/2023
- Academic Unit
- Orthopedics and Rehabilitation
- Record Identifier
- 9984304722802771
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