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. 2020 Dec 3;103(4):1-7. doi: 10.2106/JBJS.20.01010

TABLE II.

Published Papers on Lapidus Procedures and Modifications*

Study Level of Evidence No. of Patients with Follow-up No. of Surgeons Joints Stabilized or Fused Approach Fixation (in Sequence) Bone Graft Orthobiologics Distal Procedures Comments
Aiyer et al. (2016)5 III: retrospective comparative series NR 4 TMT1 + IntCunMT1 NR Plates (dorsal-medial) and screws NR NR NR Comparative study of different methods; fixation technique derived from images/figures (not described in detail in the text)
Bednarz and Manoli (2000)6 IV: case series 26 1 TMT1, MT1-2 (temporary) Dorsal (between 1st and 2nd rays) + stab medial incision Two 3.5-mm screws: Local cancellous No Bunionectomy Technique attributed to ST Hansen Jr.
1. MT1 base to MedCun 2nd screw removed at 13 weeks
2. MT1 to MT2 base
Coetzee and Wickum (2004)7 IV: retrospective case series 91 NR TMT1, MT1-2 (temporary) Dorsal (between 1st and 2nd rays) + stab medial incision A. Two 3.5-mm screws: Medial eminence + local cancellous ±PRP Bunionectomy, release of AHL, ± Akin procedure
1. MedCun to MT1 base
2. MT1 to MT2
B. Modification with 4.0-mm screws
Coetzee et al. (2004)8 IV: retrospective case series 24 NR TMT1, MT1-2 Dorsal (between the EHL and EHB) + distal incision in the first web space + medial incision A. Two 3.5-mm screws: Local cancellous No Soft-tissue release ±bunionectomy Revision surgery for failed HV correction
1. MedCun to MT1 base
2. MT1 to MT2
Conti et al. (2020)9,10 IV: case series 31 2 TMT1 Dorsal (1st TMT) 2 crossed screws: Cancellous autograft ± ±DBM Bunionectomy, ± Akin and/or modified McBride procedure The authors have reported on the same study population and technique in 2 separate publications
1. 4.0-mm MT1 to MedCun
2. 3.5-mm MedCun to MT1
DeVries et al. (2011)11 III: retrospective comparative analysis 134 1 TMT1 ± IntCunMT1 NR A. 2 crossed TMT screws ± 3rd screw from MT1 to IntCun No ±DBM or BMA Various, not standard
B. Dorsomedial locking plate ±crossed TMT screw
Faber et al. (2004)12 I: therapeutic randomized controlled trial 51 1 TMT1 Dorsal, lateral to EHL + distal incision in the first web space + medial incision Two 3.5-mm crossed screws: NR No Bunionectomy + AHL release Number of feet reported, some of which are bilateral cases
1. MedCun to MT1
2. MT1 to MedCun
Ellington et al. (2011)13 IV: retrospective case series 23 2 TMT1 ± MT1 to MT2 Dorsal (1st TMT) 2 crossed screws: Occasionally allograft/autograft No Bunionectomy, soft-tissue release Revision surgery for failed HV correction
1. MedCun to MT1
2. MT1 to MedCun ± 3rd screw MT1 to MT2
Habbu et al. (2011)14 IV: retrospective case series 268 2 TMT1 ± MT1-2 (temporary) NR Two 3.5-mm crossed screws: NR NR Soft-tissue release
1. MedCun to MT1
2. MT1 to MedCun ± 3rd screw MT1 to MT2
Jung et al. (2007)15 IV: retrospective case series 12 NR TMT1 Dorsolateral/medial Two 3.5-mm crossed screws: NR NR NR Primary diagnosis: TMT OA; fixation technique derived from images/figures (not described in detail in the text)
1. MedCun to MT1
2. MT1 to MedCun
Kazzaz and Singh (2009)16 IV: retrospective case series 19 1 TMT1 Medial Two 3.5-mm or 4.0-mm crossed screws: NR NR Soft-tissue release + Akin
1. MedCun to MT1
2. MT1 to MedCun
Klemola et al. (2017)17 III: case-control study 58 NR TMT1 NR Single, headless, variable-pitch compression screw NR NR No distal procedure
Kopp et al. (2005)18 IV: retrospective case series 29 2 TMT1 Dorsal (1st TMT) Two 3.5-mm crossed screws: Local bone graft NR Soft-tissue release ±Akin
1. MedCun to MT1
2. MT1 to MedCun ± supplementary temporary Kirschner wire
Langan et al. (2020)19 IV: retrospective case series 62 1 TMT1 + IntCunMT1 Dorsomedial, medial to the EHL Dorsomedial locking plate + 4.0-mm cannulated screw from base of MT1 to IntCun ± 4.0-mm cannulated screw from MT1 to MT2 NR NR Soft-tissue release ± bunionectomy ± Akin
Lee and Manoli (2001)20 V: Case report 1 1 TMT1 + MT1MT2 NR Two 3.5-mm screws: NR NR Akin Method of fixation is derived from images/figures (not described in detail in the text)
1. MT1 to MedCun
2. MT1 to MT2
MacMahon et al. (2016)21 IV: retrospective case series 48 6 NR NR NR NR NR NR
Ray et al. (2019)22 IV: retrospective case series 57 4 TMT1 Dorsomedial, medial to the EHL 2 small-profile, 4-hole titanium locking plates applied in biplanar 90°-90° fashion NR NR Soft-tissue release
Rippstein et al. (2012)23 IV: retrospective case series 10 1 TMT1 Dorsomedial 2 crossed 3.5-mm screws: NR NR 1st MTP fusion
1. MedCun to MT1
2. MT1 to MedCun
Sangeorzan and Hansen (1989)24 IV: retrospective case series 23 1 TMT1 ±MT1MT2 or MT1IntCun Dorsal, from the first web space to the TMT1 2 crossed 3.5-mm screws: Tricortical bone graft from iliac crest ± NR NR Authors state that their technique has changed during the study period
1. MedCun to MT1
2. MT1 to IntCun or MT2
Thompson et al. (2005)25 IV: retrospective case series 182 NR TMT1 Dorsal, from the first web space to the TMT1 ± medial MTP 2 crossed 3.5-mm screws: Local bone graft NR Soft-tissue release ± Akin Some of the procedures were part of a flatfoot reconstruction
1. MT1 to MedCun
2. MedCun to MT1
Toolan (2007)26 V: expert opinion surgical strategies NA NA TMT1 ± MT1MT2 Dorsal (1st TMT) Two 3.5-mm screws: Local bone graft NR Bunionectomy + AHL release
1. MT1 to MedCun
2. MedCun to MT1 or MT1 to MT2
*

NR = not reported, MT = metatarsal, TMT = tarsometatarsal, IntCun = intermediate cuneiform, MedCun = medial cuneiform, PRP = platelet-rich plasma, ± = with or without, AHL = abductor hallucis longus, EHL = extensor hallucis longus, EHB = extensor hallucis brevis, HV = hallux valgus, DBM = demineralized bone matrix, BMA = bone marrow aspirate, OA = osteoarthritis, MTP = metatarsophalangeal, and NA = not applicable.