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Isolated talonavicular arthrodesis and talonavicular-cuneiform arthrodesis for the Müller-Weiss disease
Hong-Hui Cao1, Wei-Zhong Lu2, Kang-Lai Tang3
1Department of Orthopaedic Surgery, Southwest Hospital, The Third Military Medical University, Gaotanyan Str. 30, Chongqing, 400038, People's Republic of China.
Background:
The 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.
Methods:
Thirty 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.
Results:
All 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.
Conclusions:
According 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.
Insights
This study shows that both talonavicular (TN) and talonavicular-cuneiform (TNC) arthrodesis effectively treat advanced Müller-Weiss disease. Patients experienced significant pain relief and improved quality of life with solid fusion rates.
Area of Science:
- Orthopedic Surgery
- Foot and Ankle Surgery
- Radiology
Background:
- Müller-Weiss disease is a degenerative condition affecting the foot.
- Advanced stages (III and IV) often require surgical intervention.
- Arthrodesis aims to fuse affected joints to relieve pain and improve function.
Purpose of the Study:
- To evaluate the clinical outcomes of isolated talonavicular (TN) arthrodesis.
- To assess the effectiveness of talonavicular-cuneiform (TNC) arthrodesis.
- To compare these surgical techniques for stage III and IV Müller-Weiss disease.
Main Methods:
- Thirty patients with stage III/IV Müller-Weiss disease were divided into TN and TNC groups based on MRI findings.
- The TN group (16 patients) underwent arthrodesis with compression screws.
- The TNC group (14 patients) received arthrodesis with osteotomy and bone grafting.
- Patients were assessed using AOFAS scores and radiographic evaluation.
Main Results:
- Both TN and TNC arthrodesis groups reported high patient satisfaction.
- Mean AOFAS scores significantly improved postoperatively in both groups (from ~40 to ~90).
- Radiographic evaluation confirmed solid fusion in all cases across both groups.
Conclusions:
- Isolated TN arthrodesis is a viable option for selected Müller-Weiss disease patients.
- TNC arthrodesis with bone grafting provides good outcomes for more extensive disease.
- Both surgical approaches lead to solid fusion and improved quality of life.
