Incidence of Nonunion Following Naviculocuneiform Arthrodesis - A Retrospective Review of 61 Cases

Abstract

Purpose: Naviculocuneiform (NC) joint arthrodesis is used in the treatment of symptomatic flatfoot, cavovarus foot deformity, posttraumatic arthritis, and degenerative joint disease to stabilize the medial column. There is currently a paucity in the literature regarding NC fusion rates, particularly when combined with adjacent joint arthrodesis. The purpose of this study is to expand on the current literature evaluating NC arthrodesis nonunion rate when performed for the treatment of adult flatfoot deformity, midfoot or rearfoot arthritis. Case Study: NC arthrodesis was performed by a single surgeon between 2015 and 2020 on 58 consecutive patients. This includes NC arthrodesis with and without adjacent joint arthrodesis, as well as rearfoot osteotomies. Postoperative radiographs were evaluated for union by each author independently. Procedures: NC arthrodesis, triple arthrodesis, medial double arthrodesis, medial column arthrodesis, tarsometatarsal arthrodesis, medial displacement calcaneal osteotomy Results: NC arthrodesis was performed in 61 consecutive cases for treatment of symptomatic pes planus deformity, midfoot or rearfoot arthritis. Revision NC arthrodesis secondary to symptomatic nonunion was performed in 4 of 61 cases (6.5%). Analysis & Discussion: There is a relative paucity in the literature regarding NC nonunion. The findings of our study are consistent with current literature, with reports ranging between 0 and 12.5%. There is currently only one published systematic review evaluating NC nonunion, which includes only NC arthrodesis without adjacent joint arthrodesis. There are a limited number of studies evaluating NC arthrodesis, with a majority having small patient populations. To date, this is the largest single study evaluating NC nonunion rate.