Short-term effectiveness of talonavicular joint arthrodesis and calcaneus osteotomy for Müller-Weiss disease_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

QU Fufeng ¹ , CAI Jie ¹ ,  LIANG Xiaojun ² , LI Yi ² , LU Jun ² , JI Weina ² , ZENG Qiu ²

1. Xi’an Medical University, Xi’an Shaanxi, 710068, P.R.China;
2. Department of Foot and Ankle Surgery, Honghui Hospital, Xi’an Jiaotong University, Xi’an Shaanxi, 710054, P.R.China;

Corresponding author：

LIANG Xiaojun, Email: hhyyqff@163.com

Keywords：

Müller-Weiss disease; talonavicular joint arthrodesis; calcaneus osteotomy

DOI：

10.7507/1002-1892.201805036

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Objective To investigate the short-term effectiveness of talonavicular joint arthrodesis and calcaneus osteotomy in the treatment of Müller-Weiss disease. Methods Between June 2015 and February 2017, 14 patients diagnosed Müller-Weiss disease, who were ineffective on conservative treatment, were treated with talonavicular joint arthrodesis and calcaneus osteotomy. There are 3 males and 11 females, with an average age of 46.2 years (range, 35-56 years). According to the Maceira grading criteria, 5 patients were rated as stage Ⅲ and 9 patients as stage Ⅳ. The disease duration ranged from 4 to 12 years (mean, 7 years). Preoperative X-ray films showed that all patients were not accompanied with adjacent joint arthritis. The hindfoot axis on Saltzman view was (9.8±2.8)°, calcaneal pitch angle (CPA) on lateral position was (14.7±5.1)°, Meary angle on lateral position was (4.8±2.8)°, and talar 1 meta-tarsal angle (T1MA) on anteroposterior position was (25.0±7.3)°. Preoperative visual analogue scale (VAS) score was 5.9±1.5, American Orthopedic Foot Ankle Society (AOFAS) ankle-hindfoot score was 58.8±17.6. Results All patients were followed up 14-27 months (mean, 22.3 months). Medial numbness and incision infection occurred in 2, 2 cases, respectively. The other patients had no obvious discomfort. At last follow-up, VAS score was 1.6±1.3 and AOFAS score was 90.6±2.7, showing significant differences when compared with preoperative ones (t=8.18, P=0.00; t=–6.95, P=0.00). X-ray films showed that the talonavicular joint and calcaneus osteotomy achieved bony healing. The hindfoot axis on Saltzman view was (–2.5±2.7)°, CPA on lateral position was (25.0±5.2) °, Meary angle on lateral position was (2.6±2.1)°, T1MA on anteroposterior position was (8.1±3.8)°. There was no significant difference in Meary Angle between pre- and post-operation (t=1.53, P=0.15). And there were significant differences in the hindfoot axis, CPA, and T1MA between pre- and post-operation (t=11.93, P=0.00; t=–8.89, P=0.00; t=8.05, P=0.00). Conclusion For Müller-Weiss disease patients without adjacent joint arthritis, who are ineffective on conservative treatment, the satisfied short-term effectiveness can be obtained when treated by talonavicular joint arthrodesis and calcaneus osteotomy.

Citation： QU Fufeng, CAI Jie, LIANG Xiaojun, LI Yi, LU Jun, JI Weina, ZENG Qiu. Short-term effectiveness of talonavicular joint arthrodesis and calcaneus osteotomy for Müller-Weiss disease. Chinese Journal of Reparative and Reconstructive Surgery, 2019, 33(2): 166-169. doi: 10.7507/1002-1892.201805036 Copy

1.	Fornaciari P, Gilgen A, Zwicky L, et al. Isolated talonavicular fusion with tension band for Muller-Weiss syndrome. Foot Ankle Int, 2014, 35(12): 1316-1322.
2.	Mohiuddin T, Jennison T, Damany D. Müller-Weiss disease-Review of current knowledge. Foot Ankle Surg, 2014, 20(2): 79-84.
3.	Samim M, Moukaddam HA, Smitaman E. Imaging of Mueller-Weiss syndrome: A review of clinical presentations and imaging spectrum. AJR Am J Roentgenol, 2016, 207(2): W8-W18.
4.	胡东, 张言, 梁晓军, 等. 单纯距舟关节融合术治疗 Müller-Weiss 病疗效分析. 中国修复重建外科杂志, 2017, 31(12): 1434-1437.
5.	Cao HH, Lu WZ, Tang KL. Isolated talonavicular arthrodesis and talonavicular-cuneiform arthrodesis for the Müller-Weiss disease. J Orthop Surg Res, 2017, 12(1): 83.
6.	Lui TH. Arthroscopic triple arthrodesis in patients with Müller Weiss disease. Foot Ankle Surg, 2009, 15(3): 119-122.
7.	Janositz G, Sisák K, Tóth K. Percutaneous decompression for the treatment of Mueller-Weiss syndrome. Knee Surg Sports Traumatol Arthrosc, 2011, 19(4): 688-690.
8.	Tosun B, AI F, Tosun A. Spontaneous osteonecrosis of the tarsal navicular in an adult: Mueller-Weiss syndrome. J Foot Ankle Surg, 2011, 50(2): 221-224.
9.	Maceira E, Rochera R. Müller-Weiss disease: clinical and biomechanical features. Foot Ankle Clin, 2004, 9(1): 105-125.
10.	Turner NM, van de Leemput AJ, Draaisma JM, et al. Validity of the visual analogue scale as an instrument to measure self-efficacy in resuscitation skills. Med Educ, 2008, 42(5): 503-511.
11.	Kitaoka HB, Alexander IJ, Adelaar RS, et al. Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int, 1994, 15(7): 349-353.
12.	Doyle T, Napier RJ, Wong-Chung J. Recognition and management of Müller-Weiss disease. Foot Ankle Int, 2012, 33(4): 275-281.
13.	Huson A. Biomechanics of the tarsal mechanism. A key to the function of the normal human foot. J Am Podiatr Med Assoc, 2000, 90(1): 12-17.
14.	Prichasuk S, Subhadrabandhu T. The relationship of pes planus and calcaneal spur to plantar heel pain. Clin Orthop Relat Res, 1994, (306): 192-196.
15.	Buck FM, Hoffmann A, Mamisch-Saupe N, et al. Hindfoot alignment measurements: rotation-stability of measurement techniques on hindfoot alignment view and long axial view radiographs. AJR Am J Roentgenol, 2011, 197(3): 578-582.
16.	Chi TD, Toolan BC, Sangeorzan BJ, et al. The lateral column lengthening and medial column stabilization procedures. Clin Orthop Relat Res, 1999, (365): 81-90.
17.	Lu CK, Fu YC, Cheng YM, et al. Isolated talonavicular arthrodesis for Müller-Weiss disease. Kaohsiung J Med Sci, 2014, 30(9): 471-476.
18.	Avila A, Li S, Myerson M, et al. The use of isolated calcaneus osteotomy in the treatment of Müller Weiss disease. Foot Ankle Surg, 2016, 22(2): 83.
19.	Li SY, Myerson MS, Monteagudo M, et al. Efficacy of calcaneus osteotomy for treatment of symptomatic Müller-Weiss disease. Foot Ankle Int, 2017, 38(3): 261-269.

1. Fornaciari P, Gilgen A, Zwicky L, et al. Isolated talonavicular fusion with tension band for Muller-Weiss syndrome. Foot Ankle Int, 2014, 35(12): 1316-1322.
2. Mohiuddin T, Jennison T, Damany D. Müller-Weiss disease-Review of current knowledge. Foot Ankle Surg, 2014, 20(2): 79-84.
3. Samim M, Moukaddam HA, Smitaman E. Imaging of Mueller-Weiss syndrome: A review of clinical presentations and imaging spectrum. AJR Am J Roentgenol, 2016, 207(2): W8-W18.
4. 胡东, 张言, 梁晓军, 等. 单纯距舟关节融合术治疗 Müller-Weiss 病疗效分析. 中国修复重建外科杂志, 2017, 31(12): 1434-1437.
5. Cao HH, Lu WZ, Tang KL. Isolated talonavicular arthrodesis and talonavicular-cuneiform arthrodesis for the Müller-Weiss disease. J Orthop Surg Res, 2017, 12(1): 83.
6. Lui TH. Arthroscopic triple arthrodesis in patients with Müller Weiss disease. Foot Ankle Surg, 2009, 15(3): 119-122.
7. Janositz G, Sisák K, Tóth K. Percutaneous decompression for the treatment of Mueller-Weiss syndrome. Knee Surg Sports Traumatol Arthrosc, 2011, 19(4): 688-690.
8. Tosun B, AI F, Tosun A. Spontaneous osteonecrosis of the tarsal navicular in an adult: Mueller-Weiss syndrome. J Foot Ankle Surg, 2011, 50(2): 221-224.
9. Maceira E, Rochera R. Müller-Weiss disease: clinical and biomechanical features. Foot Ankle Clin, 2004, 9(1): 105-125.
10. Turner NM, van de Leemput AJ, Draaisma JM, et al. Validity of the visual analogue scale as an instrument to measure self-efficacy in resuscitation skills. Med Educ, 2008, 42(5): 503-511.
11. Kitaoka HB, Alexander IJ, Adelaar RS, et al. Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int, 1994, 15(7): 349-353.
12. Doyle T, Napier RJ, Wong-Chung J. Recognition and management of Müller-Weiss disease. Foot Ankle Int, 2012, 33(4): 275-281.
13. Huson A. Biomechanics of the tarsal mechanism. A key to the function of the normal human foot. J Am Podiatr Med Assoc, 2000, 90(1): 12-17.
14. Prichasuk S, Subhadrabandhu T. The relationship of pes planus and calcaneal spur to plantar heel pain. Clin Orthop Relat Res, 1994, (306): 192-196.
15. Buck FM, Hoffmann A, Mamisch-Saupe N, et al. Hindfoot alignment measurements: rotation-stability of measurement techniques on hindfoot alignment view and long axial view radiographs. AJR Am J Roentgenol, 2011, 197(3): 578-582.
16. Chi TD, Toolan BC, Sangeorzan BJ, et al. The lateral column lengthening and medial column stabilization procedures. Clin Orthop Relat Res, 1999, (365): 81-90.
17. Lu CK, Fu YC, Cheng YM, et al. Isolated talonavicular arthrodesis for Müller-Weiss disease. Kaohsiung J Med Sci, 2014, 30(9): 471-476.
18. Avila A, Li S, Myerson M, et al. The use of isolated calcaneus osteotomy in the treatment of Müller Weiss disease. Foot Ankle Surg, 2016, 22(2): 83.
19. Li SY, Myerson MS, Monteagudo M, et al. Efficacy of calcaneus osteotomy for treatment of symptomatic Müller-Weiss disease. Foot Ankle Int, 2017, 38(3): 261-269.

Chinese Journal of Reparative and Reconstructive Surgery

Short-term effectiveness of talonavicular joint arthrodesis and calcaneus osteotomy for Müller-Weiss disease

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