Spontaneous Osteonecrosis of the Tarsal Navicular in an Adult: Mueller-Weiss Syndrome

Tosun, Bilgehan; Al, Firat; Tosun, Alptekin

doi:10.1053/j.jfas.2010.10.019

Cited by 45 publications

(42 citation statements)

References 8 publications

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“…Maceira [5] further describes the disease by developing a five-stage classification system using lateral weightbearing radiograph, showing a progressive collapse of the medial arch and compression and splitting of the tarsal navicular. It should be distinguished from Köhler’s disease [4], which occurs osteochondrosis of the tarsal navicular in children, and from secondary to systemic diseases (rheumatoid arthritis, SLE, renal failure, diabetes) or trauma [7]. …”

Section: Discussionmentioning

confidence: 99%

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Isolated talonavicular arthrodesis and talonavicular-cuneiform arthrodesis for the Müller-Weiss disease

Cao

Tang

2017

J Orthop Surg Res

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BackgroundThe study aimed to introduce the isolated talonavicular and talonavicular-cuneiform arthrodesis for the stage III and IV Müller-Weiss disease and analyze their clinical outcomes.MethodsThirty patients of stage III and IV Müller-Weiss disease were divided into the talonavicular (TN) arthrodesis group and the talonavicular-cuneiform (TNC) arthrodesis group according to the perinavicular osteoarthritis by MRI scans. For the isolated talonavicular arthrodesis group, 16 patients underwent talonavicular arthrodesis with two 4.0 mm hollow headless compression screws. For the TNC arthrodesis group, 14 patients were received the TNC arthrodesis with reverse “V” shape osteotomy and autoallergic iliac bone graft. All patients were followed up at 3, 6, 9, and 12 months, and per 6 months after 1 year, by the AOFAS ankle-midfoot scores, and evaluated by radiographic measurements.ResultsAll of them were followed up in two groups and all patients were satisfied with their clinical results. At the TN arthrodesis group, the patients’ mean was 39.8 months (range, 11–66 months) follow-up. The mean AOFAS ankle and hindfoot scores had improved from 38.3 ± 5.1 preoperatively to 88.9 ± 1.9 at the last postoperative assessment. At the TNC arthrodesis group, the mean follow-up was 51.7 months (range, 12–90 months). The mean AOFAS ankle and hindfoot scores were 40.1 ± 7.9 preoperatively to 90.1 ± 2.0 at the last postoperative. All of the cases were solid fusion on the radiograph.ConclusionsAccording to MRI evaluation, either TN or TNC arthrodesis for stage III or IV Müller-Weiss disease have the good clinical outcomes with solid fusion rate and obvious improvement of the quality of life of patients.

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Section: Discussionmentioning

confidence: 99%

“…There is no gold standard surgical technique that is effective and safe for the treatment of MWD disease. But early diagnosis and proper treatment are essential for patients’ recovery [7]. Traditionally, the standard tools for the diagnosis of MWD disease and judgment of the stage are weightbearing plain radiographs of the foot.…”

Section: Discussionmentioning

confidence: 99%

Isolated talonavicular arthrodesis and talonavicular-cuneiform arthrodesis for the Müller-Weiss disease

Cao

Tang

2017

J Orthop Surg Res

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“…The navicular is also susceptible to osteochondrosis (Kohler's syndrome) in the pediatric population and to avascular necrosis in the adult population (Mueller-Weiss syndrome). 37 In the midfoot, diffuse muscle atrophy and fatty replacement may be seen on T1 sequences due to more proximal denervation or in patients with diabetes. The exact etiology of this phenomenon in patients with diabetes is debated but may be secondary to denervation or vasculopathy.…”

Section: [ Clinical Commentary ]mentioning

confidence: 99%

The Pearls and Pitfalls of Magnetic Resonance Imaging of the Lower Extremity

Tall

Thompson²,

Greer³

et al. 2011

J Orthop Sports Phys Ther

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“…Operative treatment should be considered when conservative treatment failed to relieve the symptom [7]. Several operative techniques have been proposed for midfoot pain relief and deformity correction: internal fixation of navicular bone, simple excision of the dorsolateral fragment of the navicular with bone graft [10, 14], percutaneous drilling decompression [12], isolated talonavicular arthrodesis [10, 15, 16], talonavicular-cuneiform (TNC) arthrodesis [7], and double fusion or triple arthrodesis [8]. However, it remains uncertain that which kind of treatment is the best method to treat which type of MWD.…”

Section: Introductionmentioning

confidence: 99%

Open triple fusion versus TNC arthrodesis in the treatment of Mueller-Weiss disease

Zhang

Qiao

et al. 2017

J Orthop Surg Res

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BackgroundMueller-Weiss disease is a rarely diagnosed deformity where the navicular bone undergoes spontaneous osteonecrosis in adults. Until now, there is no widely accepted operative treatment for this unusual disease. We aimed to compare clinical and radiological outcomes between the open triple fusion and talonavicular-cuneiform arthrodesis for Mueller-Weiss disease of stage 4.MethodsDuring the period from February 2012 to June 2016, 10 patients (11 feet) suffering from Mueller-Weiss disease of stage 4 were treated by the same senior surgeon. Among them, 5 patients (5 feet) were treated with open triple fusion and 5 patients (6 feet) were treated with talonavicular-cuneiform arthrodesis. Clinical outcomes were evaluated by American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score. Radiological results were assessed based on the X-ray and CT. Postoperative complications were also recorded.ResultsThere were no significant differences in AOFAS score between the two groups (p = 0.1 > 0.05). For the open triple fusion, the average AOFAS ankle-hindfoot score improved from 30.2 ± 3.27 preoperatively to 79 ± 3.81 at the last follow-up (p = 0.008). And for the talonavicular-cuneiform (TNC) arthrodesis, the average AOFAS ankle-hindfoot score improved from 33.2 ± 5.63 preoperatively to 86.2 ± 3.49 at the last follow-up (p = 0.007).ConclusionsBoth triple fusion and TNC arthrodesis are reasonable methods for the treatment of Mueller-Weiss disease if properly used. It is crucial to use radiological assessment to evaluate the involved joints preoperatively and then chose the appropriate method to treat different patients.

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Spontaneous Osteonecrosis of the Tarsal Navicular in an Adult: Mueller-Weiss Syndrome

Cited by 45 publications

References 8 publications

Isolated talonavicular arthrodesis and talonavicular-cuneiform arthrodesis for the Müller-Weiss disease

Isolated talonavicular arthrodesis and talonavicular-cuneiform arthrodesis for the Müller-Weiss disease

The Pearls and Pitfalls of Magnetic Resonance Imaging of the Lower Extremity

Open triple fusion versus TNC arthrodesis in the treatment of Mueller-Weiss disease

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