Rates of Lapidus Procedures in the US Military Before and After the Advent of and Advocacy for Tri-Plane Lapidus Corrective Surgery

• Published in: The Journal of foot and ankle surgery Vol. 62; no. 2; pp. 327 - 332
• Main Authors: Nelson, D. Alan, Huh, Jeannie, Clifton, Daniel R., Edgeworth, Daniel B., Shell, Donald, Choi, Y. Sammy, Deuster, Patricia A.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-03-2023
• Subjects: arthrodesis, foot surgery; hallux valgus, lapidus, military medicine; tri-plane corrective Lapidus surgery; arthrodesis, foot surgery; hallux valgus, lapidus, military medicine; 3; tri-plane corrective Lapidus surgery
• ISSN: 1067-2516; 1542-2224
• DOI: 10.1053/j.jfas.2022.08.010

Tri-plane corrective Lapidus surgery has been described as advantageous with respect to its anatomic basis and outcomes. Because the procedure has been broadly publicized, changes in overall Lapidus procedure rates due to increased numbers of patients opting for the tri-plane approach could have occurred. Data supporting this possibility appears lacking. We employed official personnel and health records of the total active-duty US military to conduct a retrospective cohort study of Lapidus surgery rates before and after the advent of the tri-plane corrective Lapidus procedure. Least-squares and locally-weighted scatterplot smoother regression functions were used to confirm time trends. Sociodemographic and occupational traits of Lapidus patients were compared using 2-sided t tests and chi square tests. Lapidus surgery rates among hallux valgus patients decreased during 2014 to 2016 and increased during 2017 to 2021. While multiple factors might explain these trends, they coincide with the advent of and advocacy for tri-plane Lapidus surgery. The results support the possibility that its rise influenced overall Lapidus rates in this population. As these findings represent limited evidence of such an influence, further research is required to confirm a causal link. If such a link is found, and if the ongoing research suggests that superior outcomes are associated with tri-plane Lapidus surgery, substantial implications could exist for this population. Benefits might include enhanced medical readiness due to the importance of lower extremity function during military duties. Additional research is needed to confirm the impact of the procedure and to determine whether Lapidus surgery rate patterns in civilian populations mirror these findings.