Peri-Navicular Arthrodesis for the Stage III Müller-Weiss Disease

Abstract

Background: We aimed to report our results of peri-navicular arthrodesis with autologous iliac bone graft for Stage III Müller-Weiss disease. Methods: Nine cases of Stage III Müller-Weiss disease according to the Maceira classification (four male and five female) with average age of 48.2 (range, 41 to 58) years, had mild or severe midfoot pain with the longitudinal arch collapse. The patients, all of whom had failed conservative treatment for more than 6 months, underwent peri-navicular arthrodesis. All patients were followed up at 3, 6, 9, and 12 months, and then every 6 months with AOFAS ankle-hindfoot scores and radiographic measurements. Mean followup time for radiological and clinical evaluation was 22.4 (rangem 12 to 52) months. Results: All patients were satisfied with their clinical results without pain 12 months after surgery. The mean AOFAS ankle-hindfoot scores improved from 40.1 ± 8.3 preoperatively to 90.9 ± 2.1 at the last followup ( p < 0.05). A solid fusion was found in all cases at 3 months after surgery by radiographic and clinical evaluation. The average longitudinal arch height increased from 46.1 ± 2.1 mm preoperatively to 53.5 ± 2.3 mm at the last followup ( p < 0.05) on the lateral weightbearing radiograph. Conclusion: The peri-navicular arthrodesis with autologous iliac bone graft resulted in a good outcome for Stage III Müller-Weiss disease with good clinical outcomes, high fusion rate, and obvious improvement of the longitudinal arch height. Level of Evidence: IV, Retrospective Case Series