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Early results and complication rate of the LapiCotton procedure in the treatment of medial longitudinal arch collapse: a prospective cohort study.

Publication ,  Journal Article
de Cesar Netto, C; Ehret, A; Walt, J; Chinelati, RMK; Dibbern, K; de Carvalho, KAM; Tazegul, TE; Lalevee, M; Mansur, NSB
Published in: Arch Orthop Trauma Surg
May 2023

INTRODUCTION: 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. METHODS: 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. RESULTS: 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). CONCLUSION: 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 OF EVIDENCE: Level II, prospective cohort study.

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Published In

Arch Orthop Trauma Surg

DOI

EISSN

1434-3916

Publication Date

May 2023

Volume

143

Issue

5

Start / End Page

2283 / 2295

Location

Germany

Related Subject Headings

  • Talus
  • Retrospective Studies
  • Prospective Studies
  • Orthopedics
  • Metatarsal Bones
  • Humans
  • Hallux Valgus
  • Foot Joints
  • Flatfoot
  • Arthritis
 

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de Cesar Netto, C., Ehret, A., Walt, J., Chinelati, R. M. K., Dibbern, K., de Carvalho, K. A. M., … Mansur, N. S. B. (2023). Early results and complication rate of the LapiCotton procedure in the treatment of medial longitudinal arch collapse: a prospective cohort study. Arch Orthop Trauma Surg, 143(5), 2283–2295. https://doi.org/10.1007/s00402-022-04399-0
Cesar Netto, Cesar de, Amanda Ehret, Jennifer Walt, Rogerio Marcio Kajimura Chinelati, Kevin Dibbern, Kepler Alencar Mendes de Carvalho, Tutku Erim Tazegul, Matthieu Lalevee, and Nacime Salomão Barbachan Mansur. “Early results and complication rate of the LapiCotton procedure in the treatment of medial longitudinal arch collapse: a prospective cohort study.Arch Orthop Trauma Surg 143, no. 5 (May 2023): 2283–95. https://doi.org/10.1007/s00402-022-04399-0.
de Cesar Netto C, Ehret A, Walt J, Chinelati RMK, Dibbern K, de Carvalho KAM, et al. Early results and complication rate of the LapiCotton procedure in the treatment of medial longitudinal arch collapse: a prospective cohort study. Arch Orthop Trauma Surg. 2023 May;143(5):2283–95.
de Cesar Netto, Cesar, et al. “Early results and complication rate of the LapiCotton procedure in the treatment of medial longitudinal arch collapse: a prospective cohort study.Arch Orthop Trauma Surg, vol. 143, no. 5, May 2023, pp. 2283–95. Pubmed, doi:10.1007/s00402-022-04399-0.
de Cesar Netto C, Ehret A, Walt J, Chinelati RMK, Dibbern K, de Carvalho KAM, Tazegul TE, Lalevee M, Mansur NSB. Early results and complication rate of the LapiCotton procedure in the treatment of medial longitudinal arch collapse: a prospective cohort study. Arch Orthop Trauma Surg. 2023 May;143(5):2283–2295.
Journal cover image

Published In

Arch Orthop Trauma Surg

DOI

EISSN

1434-3916

Publication Date

May 2023

Volume

143

Issue

5

Start / End Page

2283 / 2295

Location

Germany

Related Subject Headings

  • Talus
  • Retrospective Studies
  • Prospective Studies
  • Orthopedics
  • Metatarsal Bones
  • Humans
  • Hallux Valgus
  • Foot Joints
  • Flatfoot
  • Arthritis