Arthrodesis in Müller-Weiss disease: is it worth keeping the navicular bone?

Abstract

Objective: Compare a case series diagnosed with Müller-Weiss disease and whether or not maintaining the diseased navicular bone influences the outcome of the arthrodesis. Methods: A retrospective clinical study that evaluated patients with Müller-Weiss disease (phases 3 and 4 of Maceira’s classification) submitted to surgery. The patients were divided into two groups. Group A included six patients (six feet), in whom all the navicular bone was removed, and a tricortical graft was used to replace it. Group B also included six patients (six feet) without removed navicular bone. The mean follow-up time was 101 months. For evaluation, clinical and radiographic criteria were used, including The American Orthopaedic Foot & Ankle Society (AOFAS) scale for ankle and hindfoot and the Visual Analog Scale (VAS). Results: The mean consolidation time for arthrodesis was 18 weeks in group A and 16 weeks in group B. The radiographic angles in the preoperative and postoperative did not show significant changes. In group A, the preoperative mean AOFAS score was 45 points, and the postoperative was 80 points. In group B, the preoperative mean AOFAS score was 48 points, and the postoperative was 79 points. The mean VAS value was 2.5 in group A and 2.4 in group B. The pseudarthrosis index was the same in both groups, 33.3% (2 of the 6 feet). Conclusion: No significant differences were found between maintaining or replacing the navicular bone by tricortical bone graft in the midfoot arthrodesis in patients with Müller-Weiss disease. Level of Evidence III; Therapeutic Studies - Investigating the Results of Treatment; Retrospective Comparative Study.

Keywords

• Arthrodesis
• Bone transplantation
• Flatfoot
• Osteochondrosis