Lapiplasty® Educational Video

Lapiplasty® Surgical Demonstration

87%
bunions have a metatarsal frontal-plane rotational deformity1
12x
likelihood of deformity recurrence if frontal-plane rotation is not corrected4
1system
designed to correct frontal-plane rotation at the anatomic CORA

Why perform the Lapiplasty® Procedure?

Because metatarsal frontal-plane rotation matters

While hallux valgus has traditionally been viewed as a transverse plane deformity, research indicates that it is actually a three-plane deformity with 87% of patients having abnormal frontal-plane rotation (i.e. pronation) of the 1st metatarsal.3 Correction of metatarsal rotation is critical for restoration of anatomic first ray alignment (MTP joint congruity and sesamoid position), which left unaddressed, is associated with up to 12x likelihood of radiographic recurrence.4,5,6 Due to the ability to address the triplanar deformity at its origin, the 1st tarsometarsal (TMT) joint provides the optimal surgical site for true anatomic restoration.


Learn more about metatarsal frontal-plane rotation.

What is the Lapiplasty® Procedure?

An instrumented, reproducible approach to 3-plane correction with rapid return to weight-bearing7

Correct.

Make your correction before you cut

The Lapiplasty® Positioner is engineered to quickly and reproducibly correct the alignment in all three planes, establishing and holding true anatomic alignment of the metatarsal and sesamoids.8

Cut.

Perform precision cuts with confidence

The Lapiplasty® Cut Guide delivers precise cuts with the metatarsal held in the corrected position, ensuring optimal cut trajectory while virtually eliminating the risk of metatarsal shortening.

Compress.

Achieve controlled compression of joint surfaces

The Lapiplasty® Compressor delivers over 150N of controlled compression9 to the precision-cut joint surfaces, while maintaining the 3-plane correction.

Fixate.

Apply multiplanar fixation for robust stability

Low-profile Biplanar™ Plating provides biomechanically-tested 10,11 multiplanar stability for rapid return to weight-bearing.7

How does the Lapiplasty® Procedure work?

Key Surgical Steps*

1. Joint Release

Run sagittal saw cengruously down the 1st TMT joint to mobilize and plane the joint surfaces.

2. Anatomic Correction

Apply the Lapiplasty® Posltioner, simultaneously securing the IM angle, frontal-plane rotation, and sagittal alignment in corrected position.

3. Precision Cuts

Secure the Lapiplasty® Cut Guide and make precise joint cuts with the triplanar correction held In place.

4. Joint Distraction

Apply the Lapiplasty® Compressor over the Cut Guide Pins to distract the joint for removal of bone slices and fenestration of the joint surfaces.

5. Joint Compression

Using·the Lapiplasty® Compressor, bring the precision-cut joint surfaces together for controlled apposition and compression of the arthrodesis site.

6. Multiplanar Fixation

Apply low-profile Biplanar™ Plates dorsally and medially, providing multiplanar fixation for rapid weight-bearing.
* Treace Medical Concepts, Inc. Surgical Technique LBL 1405-9001
Covered by one of more patents. See www.treace.com/patients

Lapiplasty® System

Anatomic Biplanar™ Implants

Lapiplasty® System 1

Sterile-packed Biplanar™ Plating kit for versatility to fit each patient's anatomy, while delivering superior multiplanar strength.
SK12
Plate Width
3.6mm
Locking Screws
2.5x12mm (5)
2.5x14mm (4)

Lapiplasty® System 2

An evolution of Biplanar™ Plating with increased cross-sectional width and 2.7mm screws for additional construct strength.
SK14
Plate Width
3.9mm
Locking Screws
2.7x12mm (5)
2.7x14mm (4)

Lapiplasty® System 3R

Most robust Biplanar™ Plating option with widest cross-section, 3.0mm screws, and increased span to address revision cases and challenging anatomy.
Plate Width
4.3mm
Locking Screws
3.0x12mm (4)
3.0x16mm (8)

Plantar Python® Plate

Sterile-packed for use with the Lapiplasty® System, the Platnar Python® Plate is uniquely pre-contoured for easy-to-apply tension-side fixation.
S1: SD11/12 (L/R) S2: SD14/15 (L/R)

One System for All Your Hallux Valgus Needs

Sterile-packed kits for operational efficiency

Lapiplasty® Compression Screws

See Instructions for Use LBL1405—9056* or LBL1405-9110**

Biomechanically Proven for Rapid Weight-Bearing

Biomechanical test specimens were constructed using Sawbones surrogate bone models (Pacific Research Laboratories Inc, Vashon, WA) and tested in cantilever bending to simulate functional lst TMT joint loading. The testing included both static ultimate failure and cyclic load to failure. Three different studies were performed under this test protocol, which are detailed below.

S1 vs Conventional Plating

Dayton et al, J Foot Ankle Surg. 2016, 55:567-71

Plantar Python® vs S1

Dayton et al, J Foot Ankle Surg. 2018, 57:766-70

S2 vs S1

Publication in process. Data on file. M171A

The Evidence-Based Solution for 3-Plane Correction

Treace Medical Concepts is dedicated to advancing the understanding of the Lapiplasty® Procedure and its benefits to patients, surgeons, and the healthcare system through research studies and publications in the peer-reviewed literature.

Multicenter Early Radiographic Outcomes of Triplanar Tarsometatarsal Arthrodesis With Early Weightbearing

Multicenter, retrospective study of 57 hallux valgus (62 feet) patients treated with the Lapiplasty® Procedure and early return to weight-bearing at mean follow-up of 13.5 months.



Ray JJ, et al. Foot Ankle Int. 2019 [published online ahead of print]
Highlights of the study:
  • Mean return to weight-bearing at 10.9 days in a walking boot
  • 96.8% of study patients maintained their 3-plane bunion correction as assessed by Intermetatarsal Angle (IMA), Hallux Valgus Angle (HVA) and Tibial Sesamoid Position (TSP)
  • Symptomatic non-union rate of 1.6% (1 foot)

Progression of Healing on Serial Radiographs Following First Ray Arthrodesis in the Foot Using a Biplanar Plating Technique Without Compression

Multicenter, retrospective study of bone healing with accelerated weightbearing protocol in 195 patients undergoing TMT or MTP fusions with Lapiplasty® biplanar plating at mean follow up of 9.5 months.

Highlights of the study:
  • Patients began weight-bearing at 5 days post-op in a walking boot
  • 97.4% of the patients demonstrated a successful bony fusion
  • 98.9% of the patients maintained a stable joint position
Dayton P, et al. Foot Ankle Surg. 2019 [published online ahead of print]
Lapiplasty® Publications
  1. Ray JJ, et al. Multicenter Early Radiographic Outcomes of Triplanar Tarsometatarsal Arthrodesis With Early Weightbearing. Foot Ankle Int. 2019, [published online ahead of print].
  2. Dayton P, et al. Progression of Healing on Serial Radiographs Following First Ray Arthrodesis in the Foot Using a Biplanar Plating Technique Without Compression. Foot Ankle Surg. 2019, [published online ahead of print].
  3. Hatch et al. Triplane Hallux Abducto Valgus Classification. J Foot Ankle Surg. 2018, 57:972–981.
  4. Dayton et al. Biomechanical Characteristics of Biplane Multiplanar Tension-Side Fixation for Lapidus Fusion. J Foot Ankle Surg. 2018, 57:766-770.
  5. Dayton (Ed.) Evidence-Based Bunion Surgery: A Critical Examination of Current and Emerging Concepts and Techniques. Springer International Publishing [Textbook]. 2018.
  6. Santrock et al. Hallux Valgus Deformity and Treatment. A Three-Dimensional Approach: Modified Technique for Lapidus Procedure. Foot Ankle Clin. 2018, 23:281-295.
  7. Smith et al. Understanding Frontal Plane Correction in Hallux Valgus Repair. Clin Podiatr Med Surg. 2018, 35:27-36.
  8. Dayton et al. Comparison of Tibial Sesamoid Position on Anteroposterior and Axial Radiographs Before and After Triplane Tarsal Metatarsal Joint Arthrodesis. J Foot Ankle Surg. 2017, 56:1041-1046.
  9. Smith et al. Intraoperative Multiplanar Alignment System to Guide Triplanar Correction of Hallux Valgus Deformity. Techniques in Foot & Ankle Surgery. 2017, 16:175-82.
  10. Dayton et al. Comparison of the Mechanical Characteristics of a Universal Small Biplane Plating Technique Without Compression Screw and Single Anatomic Plate with Compression Screw. J Foot Ankle Surg. 2016, 55:567-71.

Learn more about the Lapiplasty® System components:

Lapiplasty® Instrumentation

Lapiplasty® Instrumentation

Advanced instrumentation (reusable) that allows you to dial in your correction in three-planes with the Positioner before making controlled cuts via the precision Cut Guide.
Lapiplasty® System

Lapiplasty® System

Complete sterile-packed instrument and fixation system delivers operational efficiency while featuring Biplanar™ Plating for superior strength and durability.
Plantar Python® Plate

Plantar Python® Plate

Sterile-packed for use with the Lapiplasty® System, the Plantar Python® Plate is uniquely precontoured to provide easy-to-apply plantar-based fixation.
Covered by one or more patents, including U.S. Pat. 9,622,805. See www.treace.com/patents

Lapiplasty® Resources

Lapiplasty® Procedure Surgical Demonstration
Lapiplasty® Procedure Educational Video
Lapiplasty® Surgical Technique Animation

Lapiplasty® Overview Brochure

Lapiplasty® Procedure Key Steps

White Paper: Early Weight-Bearing 13.5 Month Multi-Center Study

Lapiplasty® Procedure Surgical Technique

Lapiplasty® Procedure Instructions For Use

Cleaning and Sterilization Instructions

Lapiplasty® Compression Screw Surgical Technique

Lapiplasty® Snap-Off Screw Surgical Technique

References

1Smith B, et al. 2017 AOFAS Annual Meeting, Seattle, WA.
2Ray JJ, et al. Foot Ankle Int. 2019.
3Kim Y, Kim JS, Young KW, et al. Foot Ankle Int. 2015, 36:944-52.
4Pentikainen I, Ojala R, Ohtonen P, et al. Foot Ankle Int. 2014, 35:1262-7.
5Okuda R, Kinoshita M, Yasuda T, et al. J Bone Joint Surg Am. 2009, 91:1637-4.
6Okuda R, Kinoshita M, Yasuda T, et al. J Bone Joint Surg Am. 2007, 89:2163-72.
7Smith B, et al. 2017 AOFAS Annual Meeting, Seattle, WA.
8Ray JJ, et al. Foot Ankle Int. 2019. (published online ahead of print)
9Data on file.
10Dayton P, et al. J Foot Ankle Surg. 2016. 55:567-71.
11Data on file.