How to treat Müller-Weiss disease: A systematic review about the treatment algorithm

Area of Science:

• Orthopedics
• Podiatry
• Radiology

Background:

• Müller-Weiss disease (MWD) is a degenerative condition affecting the navicular bone and talonavicular joint.
• It leads to sclerosis, deformity, and collapse of the navicular bone.
• Current understanding and management of MWD present challenges requiring updated treatment strategies.

Purpose of the Study:

• To systematically review and synthesize treatment outcomes for Müller-Weiss disease (MWD).
• To establish a treatment algorithm based on the radiographic and clinical stage of MWD.
• To identify limitations and challenges in current MWD understanding and management.

Main Methods:

• A PRISMA 2020-compliant systematic review of studies up to September 2023.
• Searches conducted on Pubmed and Google Scholar using keywords 'Müller-Weiss' or 'Mueller-Weiss'.
• Analysis of 25 eligible publications, assessing outcomes using the AOFAS Score.

Main Results:

• A range of treatments were analyzed, including nonoperative, joint-sparing, and fusion procedures.
• Arthrodesis was the predominant treatment, featured in 80% of studies.
• Talo-navicular-cuneiform arthrodesis was the most common fusion technique for Maceira's stages III-V.

Conclusions:

• MWD necessitates individualized management strategies.
• Early diagnosis, accurate assessment, and appropriate treatment are crucial for MWD.
• While no gold standard exists, talo-navicular-cuneiform arthrodesis shows significant promise for deformity correction and symptom relief in MWD.