Treatment of Spontaneous Osteonecrosis of the Tarsal Navicular With a Free Medial Femoral Condyle Vascularized Bone Graft: A New Approach to Managing a Difficult Problem.

Journal Article (Journal Article)

Adult-onset spontaneous osteonecrosis of the tarsal navicular joint, or Mueller-Weiss syndrome (MWS), is an uncommon debilitating disease characterized by a painful clinical course with progressive midfoot deformity. Treatment options include nonoperative management and/or operative intervention, including percutaneous decompression of the navicular bone, stabilization of existing structures, and cancellous bone grafting from the tibia or iliac crest. To our knowledge, there have been no reported cases of treatment of MWS with a vascularized bone graft. We report an unusual case of unilateral MWS in a 25-year-old male who failed nonoperative therapy and was successfully treated with a novel operative approach using debridement followed by a free medial femoral condyle vascularized bone graft. At 18-month follow-up, the patient demonstrated an excellent outcome with return to previous level of function, including work-related and recreational activities. LEVEL OF EVIDENCE: Therapeutic, Level IV: Case study.

Full Text

Duke Authors

Cited Authors

  • Levinson, H; Miller, KJ; Adams, SB; Parekh, SG

Published Date

  • August 1, 2014

Published In

Volume / Issue

  • 7 / 4

Start / End Page

  • 332 - 337

PubMed ID

  • 24368773

Electronic International Standard Serial Number (EISSN)

  • 1938-7636

Digital Object Identifier (DOI)

  • 10.1177/1938640013514270


  • eng

Conference Location

  • United States