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Operative Management for Symptomatic Accessory Navicular: A Systematic Review.
Alan P Samsonov1, James J Butler1, Kishore Konar1
1New York University Langone Health, New York University Langone Orthopedic Hospital, New York, New York.
Foot & Ankle Specialist
|September 25, 2025
Summary
Surgical intervention for accessory navicular (AN) yields satisfactory outcomes, with the Kidner procedure being the recommended technique. Other methods show higher complication or non-union rates, indicating the need for further comparative studies on AN treatment.
Area of Science:
- Orthopedic surgery
- Podiatric surgery
- Systematic review and meta-analysis
Background:
- Accessory navicular (AN) is a common foot condition requiring surgical consideration.
- Evaluating surgical outcomes for AN is crucial for guiding clinical practice.
Purpose of the Study:
- To systematically review and evaluate outcomes following surgical intervention for accessory navicular (AN).
Main Methods:
- Systematic review of Medline, Embase, and Cochrane Library databases.
- Adherence to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
- Inclusion of studies reporting surgical management outcomes for AN.
Main Results:
- Twenty-three studies involving 625 patients undergoing surgery for AN were analyzed.
- The Kidner procedure was most common (51.9%), followed by simple excision (21.5%).
- All procedures showed similar subjective improvements, but Kidner had 11% complications, while arthrodesis had 25% complications and 3% failure. Percutaneous drilling had a 42% nonunion rate.
Conclusions:
- Surgical treatment for symptomatic accessory navicular (AN) provides good clinical and radiological results.
- The Kidner procedure is recommended due to excellent outcomes and moderate complication rates.
- Arthrodesis, arthroeresis, and percutaneous drilling are not recommended due to high non-union or failure rates, highlighting the need for high-quality comparative studies.
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