New surgery helps Riverside woman run again

RIVERSIDE — Macey Greiner grew up in Keota, where she dabbled in track, golf, volleyball and especially softball throughout her high school career.

Her diagnosis with bunions at age 16 was more than a little shocking. The genetic condition leaves bones in the big toe out of place, causing joint pain and making a prominent bump in one’s foot.

“(It) was pretty horrifying, as a teenage girl,” said Greiner, now 36 and living in Riverside. “At that time, I think bunions were definitely thought of as something your grandma has … not the stereotype you want when you’re a teenage girl.”

The condition progressively got worse. Greiner said the deformity was easily visible by the middle of her college career. She started wearing only closed-toed shoes, but continued to go for runs in her spare time to stay fit.

By the time she turned 30, her condition had deteriorated, and made even short jogs a painful affair. But the doctors she spoke with still recommended against surgery, or advised waiting as long as possible to get it, citing the lengthy and often painful recovery process from most known bunion treatments.

The traditional operation involves cutting and sometimes removing parts of the affected bones, before bolting the remaining joint back into place. Doctors told Greiner it would likely take over six months per foot to return to most activities.

She eventually stumbled across the work of doctors Paul and Mindi Dayton, podiatrists in Ankeny who helped pioneer a new treatment for bunions called a “triplane metatarsal arthrodesis.” The patented technique has since been given the catchier brand name Lapiplasty.

The new procedure involved rotating and moving the entire displaced bone back into position, rather than shaving off the bump. The practice is FDA-cleared (a step below FDA approval) to treat bunions, and has been praised for its fast recovery time compared to traditional techniques, as well as its lower rate of recurrence and other complications.

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“Because of how we fixate (the bone) … they’re able to get back on their feet really quickly, and then transition back into a shoe around six weeks,” Dr. Mindi Dayton said. “Whereas, for traditional approaches and traditional hardware, they’re non-weight bearing for anywhere from four to eight weeks.”

It took a while before Greiner sought the surgery out for herself. Some providers told her to distrust reports she heard about the procedure, along with anything else she read online, much to her frustration.

But by December of 2022, Greiner went into surgery for a Lapiplasty. Her second foot was operated on shortly thereafter, in February of 2023. While that was before she finished a complete recovery from the first procedure, Greiner said she was quite capable of day-to-day activities after two months.

“I was really attracted to the shorter recovery time,” she said. “For three days after the surgery, you’re on crutches. After that, you transition to a walking boot for a couple months which seemed so much more doable than a wheelchair … I think I was just so excited to have feet that were normal.”

Today, Greiner is back to running. She goes for routine jogs, and says she can do so for about 45 minutes before she starts to feel pain in one foot.

Never a long-distance runner, she said she found her situation today quite manageable. She also appreciates the self-esteem boost that came with the operation, which corrected not only the symptoms of her bunions, but the physical deformity itself.

“It’s been amazing, to not have to worry about … toe spacers, and different arch things for my feet, to not have to worry about any of that, it’s something I take for granted now,” she said. “My main thought was, ‘I’m not going to have this problem that I have to face every day, anymore.’”

Paul and Mindi Dayton said their early research on the procedure started around 2009. By 2015, they had patented the surgical technique. The two said they were driven by the high complication rates they observed in traditional bunion treatments, as well as the frustration reported by patients who could do very little during their recovery process.

The Dayton’s studies show a roughly 3% recurrence rate for Lapiplasty patients, meaning their bunions and associated symptoms return. That’s considerably lower than the 25-70% recurrence rate reported for other treatments, depending on the study.

Still, it’s not without risks. A handful of a handful of online forums and social media discussions include patients who say they took months longer than expected to recover from their Lapiplasty, or even that the procedure made their pain worse.

Dr. Paul Dayton acknowledged the complaints, saying many issues boiled down to one’s surgeon, rather than the technique itself.

“Not every surgeon handles postoperative pain the same, not every patient handles the soft tissues you have to manipulate to get to the bones the same,” he said. “To us that’s disappointing because in our practice — and we can only speak to our practice — it’s very rare for that to happen, but again, we concentrate on all of those important factors.”

Still, the podiatrist said he and his wife were proud to have helped develop the surgical procedure, and hoped it would prove beneficial to countless others who deal with bunions every day.

“With this new way of approaching it … bunion surgery doesn’t have to be this terrible thing that it used to be by tradition,” Dr. Paul Dayton said. “We’ve come such a long way for Mindi and I in our careers, because now we can offer patients something we believe in and which is backed up by not only our own experience, but research.”

Comments: Kalen.McCain@southeastiowaunion.com