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

D. Alan Nelson; Jeannie Huh; Daniel R. Clifton; Daniel B. Edgeworth; Donald Shell; Y. Sammy Choi; Patricia A. Deuster

doi:10.1053/j.jfas.2022.08.010

Research Article| Volume 62, ISSUE 2, P327-332, March 2023

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

D. Alan Nelson, MPAS, PhD
D. Alan Nelson
Correspondence
Address correspondence to: D. Alan Nelson, MPAS, PhD, Womack Army Medical Center, Department of Research, 2817 Reilly Road, Fort Bragg, NC 28310.
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Affiliations
Womack Army Medical Center, Fort Bragg, NC, USA
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Jeannie Huh, MD, LTC, US Army
Jeannie Huh
Affiliations
San Antonio Military Medical Center, San Antonio, TX, USA
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Daniel R. Clifton, PhD, ATC
Daniel R. Clifton
Affiliations
Consortium for Health and Military Performance, Department of Military and Emergency Medicine, F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, MD, USA
Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
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Daniel B. Edgeworth, MS
Daniel B. Edgeworth
Affiliations
Consortium for Health and Military Performance, Department of Military and Emergency Medicine, F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, MD, USA
Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
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Donald Shell, MD
Donald Shell
Affiliations
Office of the Assistant Secretary of Defense – Health Affairs, Falls Church, VA, USA
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Y. Sammy Choi, MD
Y. Sammy Choi
Affiliations
Womack Army Medical Center, Fort Bragg, NC, USA
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Patricia A. Deuster, PhD, MPH
Patricia A. Deuster
Affiliations
Consortium for Health and Military Performance, Department of Military and Emergency Medicine, F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, MD, USA
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Published:August 26, 2022DOI:https://doi.org/10.1053/j.jfas.2022.08.010

Abstract

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.

Level of Clinical Evidence

3

Keywords

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Article info

Publication history

Published online: August 26, 2022

Footnotes

Financial Disclosure: This research was funded by the Defense Health Program. The authors have no financial interests or relationships to disclose.

Conflict of Interest: None reported.

Declarations of interest: none

Identification

DOI: https://doi.org/10.1053/j.jfas.2022.08.010

Copyright

Published by Elsevier Inc. on behalf of the American College of Foot and Ankle Surgeons.

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

Abstract

Level of Clinical Evidence

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