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PROstep™ MIS Bunion Surgery

Stryker’s PROstep™ minimally invasive surgery system corrects bunions through incisions only a few millimeters long, with no 3 to 5 inch incision.

What Is PROstep MIS?

PROstep™ MIS is a minimally invasive bunion surgery system made by Stryker, one of the world’s largest orthopedic companies. Traditional open bunion surgery uses an incision of about 3 to 5 inches. PROstep corrects the bunion through micro-incisions just a few millimeters long, guided by live X-ray imaging.

Dr. Johnson recently completed hands-on training in the newest minimally invasive bunion techniques and uses PROstep for patients whose bunions are well suited to this approach.

  • 76%smaller incisions on average than open bunion surgery1,2
  • 8 wksup to 8 weeks faster recovery than traditional open procedures1-3
  • 90%of MIS patients satisfied with cosmetic results, vs. 65% after open surgery1-3

How the PROstep Procedure Works

  • Micro-incisions are made at precise points along the big toe and first metatarsal.
  • Live X-ray guidance lets Dr. Johnson see the bone throughout the procedure.
  • A small burr cuts the bone so the metatarsal head can be shifted back into alignment (a minimally invasive chevron osteotomy, often paired with an Akin cut in the big toe).
  • PROstep MICA screws hold the corrected position while the bone heals.

PROstep MIS Lapidus for Unstable Bunions

Some bunions start at an unstable joint near the middle of the foot, where the first metatarsal meets the midfoot (the first tarsometatarsal, or TMT, joint). For these, a Lapidus procedure, which fuses that joint, is often the most durable fix. The PROstep MIS Lapidus system lets Dr. Johnson prepare and fuse the joint through small incisions instead of a large open approach. Stryker reports about a 76% reduction in scar size compared with open bunion correction.4

Because a fusion has to knit together, recovery after an MIS Lapidus usually includes a longer period of protected weight bearing than a chevron-style correction.

Potential Benefits

  • Smaller scars: Incisions just a few millimeters long1,2
  • Less pain: Less soft-tissue trauma than open surgery1
  • Quicker return to function: Driving, work and exercise often sooner, with Dr. Johnson’s approval2,3
  • Higher satisfaction: Higher overall patient satisfaction in published comparisons1

Who Is a Good Candidate?

PROstep MIS generally works well for patients in good overall health with good circulation, normal nerve function, healthy skin and strong bone. It may not be appropriate for people with an active infection, growth plates that are still open, or bunions that would do well with conservative care such as footwear changes or orthotics. Dr. Johnson will review your X-rays and health history to decide.

Frequently Asked Questions

Is PROstep MIS the same as a Lapiplasty or Lapifuse?

No. Lapiplasty and Lapifuse are open Lapidus-style procedures. PROstep MIS uses micro-incisions, and its MIS Lapidus option fuses the same joint through much smaller incisions. Dr. Johnson offers several approaches and will recommend the one that fits your bunion.

Is PROstep MIS covered by insurance?

Bunion surgery, including minimally invasive techniques, is usually covered when it is medically necessary. We verify your benefits before scheduling.

About these numbers. Outcome figures on this page are reported by the device manufacturers (Enovis and Stryker) and are drawn largely from published data on percutaneous chevron/Akin bunion correction compared with open surgery. They are averages, not guarantees. Your own results depend on your anatomy, the severity of your bunion, the procedure performed, and how closely you follow your recovery plan.
  1. Lam P, Lee M, Xing J, Di Nallo M. Percutaneous surgery for mild to moderate hallux valgus. Foot Ankle Clin. 2016;21(3):459-477.
  2. Lee M, Walsh J, Smith MM, Ling J, Wines A, Lam P. Hallux valgus correction comparing percutaneous chevron/Akin (PECA) and open scarf/Akin osteotomies. Foot Ankle Int. 2017;38(8):838-846.
  3. Maffulli N, et al. 2009, as cited by Enovis (betterstep.com).
  4. Stryker. PROstep MIS Lapidus launch announcement, 2023 (scar size compared with open bunion correction).

Ask About PROstep MIS

Find out whether PROstep MIS bunion surgery is the right fit for your foot.

Schedule Your Consultation Call (208) 272-9253