Skip to main content

Advertisement

SpringerLink
Log in

Assessing the Outcomes Associated with Accessory Navicular Bone Surgery—a Systematic Review

  • Management of Ankle Instability (M Hogan, Section Editor)
  • Published:
Current Reviews in Musculoskeletal Medicine Aims and scope Submit manuscript

Abstract

Purpose of Review

The purpose of this review is to evaluate the existing literature in order to compare the clinical outcomes and complications associated with the kidner procedure and simple excision procedure. Furthermore, this review will help determine if one procedure is advantageous over the other in treating accessory navicular among patients.

Recent Findings

Previous research on this topic has seen a low success rate in treating patients with symptomatic accessory navicular using conservative treatment options such as shoe-wear modification, braces, and/or nonsteroidal anti-inflammatory. Surgical treatment such as simple excision and kidner procedure has shown to have minor complications including scarring and wound irritation with a generally high satisfaction rate from patients. However, cases where patients that had planovalgus or hindfoot valgus accompanying the accessory navicular were required to undergo revision surgery to treat the recurrent pain following the kidner procedure. Similarly, patients that underwent simple excision procedure with having flat foot were unable to complete the heel test postoperatively despite not reporting feelings of pain.

Summary

Both simple excision and the Kidner procedure appear to be efficacious procedures with low complication profiles and high rates of patient satisfaction. Moreover, it has appeared that the female demographic is more likely to present symptomatic accessory navicular and undergo surgical treatment. To further explore the ideal indication for each, more prospective comparative studies are needed as well as radiological assessments pre- and post-operatively to evaluate anatomical changes in the posterior tibialis tendon area between both procedures.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Ugolini PA, Raikin SM. The accessory navicular. Foot Ankle Clin. 2004;9(1):165–80. https://doi.org/10.1016/S1083-7515(03)00176-1.

    Article  PubMed  Google Scholar 

  2. Golano P, Fariñas O, Sáenz I. The anatomy of the navicular and periarticular structures. Foot Ankle Clin. 2004;9(1):1–23. https://doi.org/10.1016/S1083-7515(03)00155-4.

    Article  PubMed  Google Scholar 

  3. Bernaerts A, Vanhoenacker FM, Van de Perre S, De Schepper AM, Parizel PM. Accessory navicular bone: not such a normal variant. JBR BTR. 2004;87(5):250–1.

    CAS  PubMed  Google Scholar 

  4. Jasiewicz B, Potaczek T, Kącki W, Tęsiorowski M, Lipik E. Results of simple excision technique in the surgical treatment of symptomatic accessory navicular bones. Foot Ankle Surg. 2008;14(2):57–61. https://doi.org/10.1016/j.fas.2007.12.002.

    Article  PubMed  Google Scholar 

  5. Prichasuk S, Sinphurmsukskul O. Kidner procedure for symptomatic accessory navicular and its relation to pes planus. Foot Ankle Int. 1995;16(8):500–3. https://doi.org/10.1177/107110079501600807.

    Article  CAS  PubMed  Google Scholar 

  6. Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan—a web and mobile app for systematic reviews. Syst Rev. 2016;5:210. https://doi.org/10.1186/s13643-016-0384-4.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Slim K, Nini E, Forestier D, Kwiatkowski F, Panis Y, Chipponi J. Methodological index for non-randomized studies (minors): development and validation of a new instrument. ANZ J Surg. 2003;73:712–6. https://doi.org/10.1046/j.1445-2197.2003.02748.x.

    Article  PubMed  Google Scholar 

  8. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33:159–74. https://doi.org/10.2307/2529310.

    Article  CAS  PubMed  Google Scholar 

  9. •• Choi HJ, Lee WC. Revision surgery for recurrent pain after excision of the accessory navicular and relocation of the tibialis posterior tendon. Clin Orthop Surg. 2017;9(2):232. https://doi.org/10.4055/cios.2017.9.2.232This article provided great insights on the complications associated with patients who had already undergone the kidner procedure in addition to providing a detailed explanation on the procedure of the revision surgery to alleviate the complications. Moreover, this paper suspected that patients with either planovalgus or hindfoot valgus were susceptible to recurrent pain after the kidner procedure from their patient demographic. This can provide an avenue for future research to investigate this potential relationship.

  10. Ray S, Goldberg VM. Surgical treatment of the accessory navicular. Clin Orthop Relat Res. 1983;177:61–6.

    Article  Google Scholar 

  11. Dawson DM, Julsrud ME, Erdmann BB, Jacobs PM, Ringstrom JB. Modified Kidner procedure utilizing a Mitek bone anchor. J Foot Ankle Surg. 1998;37(2):115–21. https://doi.org/10.1016/S1067-2516(98)80090-2.

    Article  CAS  PubMed  Google Scholar 

  12. Zeng G, Hu X, Chen Y, Yang T, Qiu X, Li C, Song W. Comparison of outcomes of arthrodesis and reconstruction (advancement), posterior tibial tendon with excision of accessory tarsal navicular bone (Kidner procedure) in type 2 accessory navicula. Foot Ankle Surg. 2020;26(8):930–4. https://doi.org/10.1016/j.fas.2019.12.005.

    Article  PubMed  Google Scholar 

  13. Kopp FJ, Marcus RE. Clinical outcome of surgical treatment of the symptomatic accessory navicular. Foot Ankle Int. 2004;25(1):27–30. https://doi.org/10.1177/107110070402500106.

    Article  PubMed  Google Scholar 

  14. Kiter E, Günal İ, Turgut A, Köse N. Evaluation of simple excision in the treatment of symptomatic accessory navicular associated with flat feet. J Orthop Sci. 2000;5(4):333–5. https://doi.org/10.1007/s007760070039.

    Article  CAS  PubMed  Google Scholar 

  15. Cha SM, Shin HD, Kim KC, Lee JK. Simple excision vs the Kidner procedure for type 2 accessory navicular associated with flatfoot in pediatric population. Foot Ankle Int. 2013;34(2):167–72. https://doi.org/10.1177/1071100712467616.

    Article  PubMed  Google Scholar 

  16. Rietveld ABM, Diemer WM. Surgical treatment of the accessory navicular (os tibiale externum) in dancers: a retrospective case series. J Dance Med Sci. 2016;20(3):103–8. https://doi.org/10.12678/1089-313X.20.3.103.

    Article  PubMed  Google Scholar 

  17. Pretell-Mazzini J, Murphy RF, Sawyer JR, Spence DD, Warner WC, Beaty JH, et al. Surgical treatment of symptomatic accessory navicular in children and adolescents. Am J Orthop. 2014;43(3):110–3.

    PubMed  Google Scholar 

  18. Macnicol MF, Voutsinas S. Surgical treatment of the symptomatic accessory navicular. J Bone Joint Surg Br. 1984;66(2):218–26. https://doi.org/10.1302/0301-620X.66B2.6707058.

    Article  CAS  PubMed  Google Scholar 

  19. Smith TR. Management of dancers with symptomatic accessory navicular: 2 case reports. J Orthop Sports Phys Ther. 2012;42(5):465–73. https://doi.org/10.2519/jospt.2012.3809.

    Article  PubMed  Google Scholar 

  20. Micheli LJ, Nielson JH, Ascani C, Matanky BK, Gerbino PG. Treatment of painful accessory navicular: a modification to simple excision. Foot Ankle Specialist. 2008;1(4):214–7. https://doi.org/10.1177/1938640008321405.

    Article  PubMed  Google Scholar 

  21. Bennett GL, Weiner DS, Leighley B. Surgical treatment of symptomatic accessory tarsal navicular. J Pediatr Orthop. 1990;10(4):445–9.

    Article  CAS  Google Scholar 

  22. • Wynn M, Brady C, Cola K, Rice-Denning J. Effectiveness of nonoperative treatment of the symptomatic accessory navicular in pediatric patients. Iowa Orthop J. 2019;39(1):45 This paper indicated very few patients were successful in managing pain with conservative treatment in which they had proceeded with surgical treatment to treat the persistent pain.

  23. •• Knapik DM, Archibald HD, Xie KK, Liu RW. A retrospective study on factors predictive of operative intervention in symptomatic accessory navicular. J Child Orthop. 2019;13(1):107–13. https://doi.org/10.1302/1863-2548.13.180168This paper found similar epidemiologic findings as our systematic review, as our data shows the female demographics has a propensity to undergo surgical management of the accessory navicular and more likely to present with symptomatic accessory naviculae.

Download references

Author information

Authors and Affiliations

  1. Division of Orthopaedic Surgery, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada

    Sajid Wariach, Kunwar Karim, Mohamed Sarraj, Amardeep Singh & Waleed Kishta

  2. Department of Orthopaedic Surgery, Mansoura International Hospital, Mansoura, Egypt

    Karim Gaber

Authors
  1. Sajid Wariach
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kunwar Karim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mohamed Sarraj
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Karim Gaber
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Amardeep Singh
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Waleed Kishta
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sajid Wariach.

Ethics declarations

Conflict of Interest

The authors have no financial or proprietary interest in any material discussed in this article.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Management of Ankle Instability

Supplementary Information

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wariach, S., Karim, K., Sarraj, M. et al. Assessing the Outcomes Associated with Accessory Navicular Bone Surgery—a Systematic Review. Curr Rev Musculoskelet Med 15, 377–384 (2022). https://doi.org/10.1007/s12178-022-09772-5

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12178-022-09772-5

Keywords

Search

Navigation