The Incidence of Nonunion of the Naviculocuneiform Joint Arthrodesis:A Systematic Review

Published:March 13, 2019DOI:


      Naviculocuneiform (NC) joint arthrodesis is an effective procedure to treat pain and provide stability to the medial column. Various forms of fixation have been described for NC arthrodesis. Despite this, the available literature is scant and questions remain regarding nonunion rate and contributory factors. A systematic review of the literature was undertaken to determine the rate of nonunion for NC joint arthrodesis. Seven studies involving 139 NC joint arthrodeses met inclusion criteria. The nonunion rate was 6.5% at a weighted mean follow-up of 73.2 months. There is insufficient evidence to provide a practice guideline based on the current literature. Adequately powered prospective clinical trials comparing well-matched patient groups with long-term follow-up are required to limit systematic error and enhance external validity. Specific outcomes measures should include union, functional assessment, complications, and cost-benefit analysis.

      Level of Clinical Evidence


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        • Miller OL
        A plastic flat foot operation.
        J Bone Joint Surg. 1927; 9: 84-91
        • Catanzariti AR
        Modified medial column arthrodesis.
        J Foot Ankle Surg. 1993; 32: 180-188
        • Ferris LR
        • Vargo R
        • Alexander IJ
        Late reconstruction of the midfoot and tarsometatarsal joints after trauma.
        Orthop Clin North Am. 1995; 26: 393-406
        • Sangeorzan BJ
        • Benirschke SK
        • Mosca V
        • Mayo KA
        • Hansen ST Jr
        Displaced intra-articular fractures of the tarsal navicular.
        J Bone Joint Surg Am. 1989; 71: 1504-1510
        • Doyle T
        • Napier RJ
        • Wong-Chung J
        Recognition and management of Muller-Weiss disease.
        Foot Ankle Int. 2012; 33: 275-281
        • Tan A
        • Smulders YC
        • Zophel OT
        Use of remodeled femoral head allograft for tarsal reconstruction in the treatment of Muller-Weiss disease.
        J Foot Ankle Surg. 2011; 50: 721-726
        • Bibbo C
        • Anderson RB
        • Davis WH
        Complications of midfoot and hindfoot arthrodesis.
        Clin Orthop. 2001; 391: 45-58
        • Ajis A
        • Geary N
        Surgical technique, fusion rates, and planovalgus foot deformity correction with naviculocuneiform fusion.
        Foot Ankle Int. 2014; 35: 232-237
        • Ford LA
        • Hamilton GA
        Naviculocuneiform arthrodesis.
        Clin Podiatr Med Surg. 2004; 21: 141-156
        • Budny AM
        • Grossman JP
        Naviculocuneiform Arthrodesis.
        Clin Podiatr Med Surg. 2007; 24: 753-763
        • Liberati A
        • Altman DG
        • Tetzlaff J
        The PRISMA statement for reporting systematic reviews and meta-analysis of studies that evaluate health care interventions: explanation and elaboration.
        J Clin Epidemiol. 2009; 62: e1-e34
        • Coleman BD
        • Khan KM
        • Maffulli N
        • Cook JL
        • Wark JD
        Studies of surgical outcome after patellar tendinopathy: clinical significance of methodological deficiencies and guidelines for future studies.
        Victorian Institute of Sport Tendon Study Group. Scand J Med Sci Sports. 2000; 10: 2-11
        • LaReaux RL
        • Hosey T
        Results of surgical treatment of talipes equino valgus by means of navicular-cuneiform arthrodesis with midcuboid osteotomy.
        J Foot Surg. 1987; 26: 412-418
        • Giannini S
        • Ceccarelli F
        • Benedetti MG
        • Faldini C
        • Grandi G
        Surgical treatment of adult idiopathic cavus foot with plantar fasciotomy, naviculocuneiform arthrodesis, and cuboid osteotomy.
        J Bone Joint Surg Am. 2002; 84: 62-69
        • Barg A
        • Brunner S
        • Zwicky L
        • Hintermann B
        Subtalar and naviculocuneiform fusion for extended breakdown of the medial arch.
        Foot Ankle Clin N Am. 2011; 16: 69-81
        • Nemec SA
        • Habbu RA
        • Anderson JG
        • Bohay DR
        Outcomes following midfoot arthrodesis for primary arthritis.
        Foot Ankle Int. 2011; 32: 355-361
        • Verhoeven N
        • Vandeputte G
        Midfoot arthritis: diagnosis and treatment.
        Foot Ankle Surg. 2012; 18: 255-262
        • Schipper ON
        • Ford SE
        • Moody PW
        • Doren BV
        • Ellington JK
        Radiographic results of nitinol compression staples for hindfoot and midfoot arthrodeses.
        Foot Ankle Int. 2018; 39: 172-179
        • Koller H
        • Kolb K
        • Zenner J
        • Reynolds J
        • Dvorak M
        • Acosta F
        • Forstner R
        • Mayer M
        • Tauber M
        • Auffarth A
        • Kathrein A
        • Hitzl W
        Study on accuracy and interobserver reliability of the assessment of odontoid fracture union using plain radiographs or CT scans.
        Eur Spine J. 2009; 18: 1659-1668