Mueller-Weiss disease

 

MWMW

 

Definition

 

Spontaneous osteonecrosis of the navicular

 

Clinical

 

Midfoot pain

 

Xray

 

Sclerosis / Fragmentation

Talonavicular osteoarthritis

Talocuneiform osteoarthritis

Midfoot collapse

 

Nav AVNnav avn

 

MWMWMW

 

MRI

 

MWMW

 

Management

 

Nonoperative

 

Orthotics

 

Harnroongroj et al Foot Ankle Int 2021

- 68 patients with Mueller-Weiss disease

- nonoperative treatment failed in presence of TN osteoarthritis

 

Operative

 

Arthrodesis

 

Depends on joints involved

Depends on degree of collapse

 

Talonavicular-cuneiform (TNC) arthrodesis

 

Uzer et al Acta Orthop Belg 2024

- 8 cases of Mueller-Weiss disease

- treated with TNC arthrodesis with plate + bone graft

- fusion 7/8 feet

 

TN versus TNC arthrodesis

 

Cao et al J Orthop Surg Res 2017

- 30 cases Mueller Weiss

- half treated with talonavicular arthrodesis and half with TNC arthrodesis

- no difference in outcomes

 

TNC versus triple arthrodesis

 

Zhang et al J Orthop Surg Res 2017

- 11 cases of Mueller Weiss

- half treated with TNC arthrodesis, half with triple arthrodesis

- no difference in outcomes