Clinical Outcomes of Lapidus Arthrodesis With Nitinol Staples for Hallux Valgus Correction.

Background: This study evaluated postoperative outcomes following Lapidus arthrodesis (fusion of the first tarsometatarsal joint [TMT1]) using two nitinol staples for hallux valgus correction, focusing on fusion rate, reoperation rate, and patient satisfaction.

Methods: A total of 60 cases undergoing Lapidus arthrodesis between June 2018 and June 2022 were analyzed with a median follow-up of 37 months (range: 15-64 months). All cases were treated using two nitinol staples (BME Elite^TM; DePuy Synthes) for TMT1 fusion. Among these, 38 cases involved additional foot procedures, while 22 cases had isolated TMT1 fusion. Data were collected from medical records, radiographs, and a telephone survey. The hallux valgus angle (HVA) and intermetatarsal angle (IMA) were measured preoperatively and postoperatively on weightbearing dorsoplantar radiographs. Functional outcomes were assessed using the Foot and Ankle Ability Measure-Activities of Daily Living (FAAM-ADL) subscale, and patient satisfaction was evaluated using a 4-point Likert scale.

Results: The TMT1 fusion rate was 96.7% (58/60). The reoperation rate-including hardware removal, revision surgery for recurrence, and nonunion-was 16.7%. The staple breakage rate was 3.3%. The IMA improved from 15.8 to 8.9 degrees (P < .001), and the HVA improved from 37.5 to 17.3 degrees (P < .001). The average FAAM-ADL score was 81.7 out of 84, with 90% of patients reporting being very satisfied or satisfied.

Conclusion: The Lapidus arthrodesis, fixed with nitinol staples, resulted in high rates of fusion and patient satisfaction.

Level of evidence: IV, retrospective cohort study.