Talonavicular Arthrodesis in Hauts-de-Seine
Foot Surgery
What is a talonavicular arthrodesis?
Dr Simon Tournemine in Hauts-de-Seine (92)
Talonavicular osteoarthritis is the progressive degeneration of the joint between the talus (ankle bone) and the navicular bone of the foot. Under normal circumstances, these bones are covered by a smooth layer of articular cartilage, allowing painless and unrestricted movement. Osteoarthritis develops as this cartilage gradually wears away, leading to progressive joint degeneration.
This condition is common, with approximately 80% of people over the age of 80 showing signs of osteoarthritis.
Progressively worsening pain is usually the first symptom. It is typically located on the dorsum of the foot, although it may radiate towards the ankle or the toes. The pain increases with walking and weight-bearing activities and is relieved by rest.
Talonavicular arthrodesis consists of removing the damaged joint surfaces before permanently fusing the two bones together, thereby eliminating painful joint movement.
Talonavicular Arthrodesis
Specialist in Foot Surgery in Hauts-de-Seine (92)
A skin incision of approximately 5 cm is made over the dorsum of the foot above the affected joint.
The worn articular cartilage is removed and the underlying bone surfaces are carefully prepared to promote bone healing.
The joint is then positioned in its optimal alignment and stabilised using surgical screws and staples.
The implanted hardware is generally well tolerated and does not usually require removal.
The procedure takes approximately 45 minutes.
It is performed under either general anaesthesia or regional anaesthesia (where only the foot is anaesthetised). The most appropriate anaesthetic technique will be discussed during your consultation with the anaesthetist.
Talonavicular Arthrodesis in Rueil-Malmaison
Foot Surgery in Hauts-de-Seine
When should talonavicular arthrodesis be performed?
Although osteoarthritis cannot be cured, several conservative treatments can help relieve symptoms.
Initial management generally includes:
- weight reduction where appropriate;
- maintaining regular low-impact physical activity;
- appropriate supportive footwear;
- pain-relieving medication such as paracetamol;
- non-steroidal anti-inflammatory drugs (NSAIDs);
- corticosteroid injections into the joint to relieve pain, although these do not reverse the arthritic process.
When these treatments no longer provide adequate symptom relief, talonavicular arthrodesis may be recommended.
Postoperative care and rehabilitation following talonavicular arthrodesis
The procedure is performed as day-case (outpatient) surgery, allowing you to return home on the day of the operation.
Pain management is closely supervised to maximise comfort and facilitate recovery.
Anticoagulant treatment is prescribed throughout the immobilisation period to reduce the risk of deep vein thrombosis.
The foot and ankle are immobilised for six weeks to allow successful bone fusion.
During this period, walking is permitted without weight-bearing using two crutches.
After approximately six weeks, the cast is removed and progressive weight-bearing begins while returning to normal footwear.
Driving generally becomes possible after approximately two months, while sporting activities may usually be resumed after around three months.
Physiotherapy begins after immobilisation has been discontinued to restore muscle strength and optimise foot mobility.
Recovery times represent average estimates and may vary according to individual healing.
Regular clinical and radiographic follow-up is recommended to monitor bone healing and identify any potential complications.
Risks and complications of talonavicular arthrodesis
Every precaution is taken to maximise healing. Nevertheless, as with any surgical procedure, certain complications may occur, although they remain uncommon:
- deep vein thrombosis (DVT) and pulmonary embolism, with the risk reduced through anticoagulant treatment;
- worsening of pre-existing medical conditions such as heart disease or diabetes, monitored by the anaesthetic team;
- infection (risk below 1%). Should infection occur, further surgery to clean the operative site together with antibiotic treatment may be required;
- haematoma, which may occasionally require drainage or blood transfusion;
- injury to small sensory nerve branches supplying the ankle and foot, potentially resulting in areas of reduced sensation;
- non-union (pseudarthrosis), where the two bones fail to fuse successfully. This uncommon complication may require prolonged immobilisation or revision surgery to achieve bone healing;
- Complex Regional Pain Syndrome (CRPS), a painful inflammatory condition that remains poorly understood. It is treated medically and may persist for several months, or occasionally several years, requiring specialised rehabilitation, additional investigations and dedicated pain management. Its occurrence and long-term evolution remain unpredictable;
- implant-related irritation, where the fixation hardware causes discomfort or irritation of adjacent tissues. In some cases, removal of the hardware may subsequently be required.
These represent the principal potential complications, although this list is not exhaustive. Rare and exceptional complications may also occur. Your surgeon will discuss your individual circumstances during your consultation.
Results of talonavicular arthrodesis
Following successful fusion, the talonavicular joint is permanently immobilised, but this generally does not impair walking, as neighbouring joints compensate for the loss of movement.
Provided that the remaining joints of the foot remain healthy, activities such as skiing, cycling, running, tennis and other sports can usually be resumed.
Most patients achieve a pain-free return to everyday activities approximately three months after surgery.
