How Do You Treat Talonavicular Joint Pain?

Written by Donaldson Thomas
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How Do You Treat Talonavicular Joint Pain

This joint is a joint consisting of the ankle, the lower half of the ankle joint, and the foot bone that lies directly in front of it, called the navicular bone.

The talonavicular joint is crucial in allowing the foot to move in and out, as well as in a circular motion.

When this joint wears down, either due to trauma to the joint or inflammation from a disease such as rheumatoid arthritis, the cartilage in this joint can wear away and become arthritic, often causing stiffness and pain

Pathology

Unfortunately, there is currently no possibility of replacing these joints damaged by osteoarthritis.

Therefore, when the pain is no longer controlled by the medical treatment put in place, arthrodesis (blocking) remains the solution of choice to obtain a functional and pain-free foot

Talonavicular Joint Pain

Today, it is preferable as much as possible to limit arthrodesis to the level of the interline spaces directly affected by the deformation or by the degenerative process

Conservation of the torque at the other joint improved the adaptability of the foot to the ground, the damping effect, and propulsion.

This talonavicular joint arthritis is responsible for essentially mechanical pain when starting, during exercise, which can progress to nocturnal pain

This is associated with deformation of the foot due to osteophytes and changes in the axes making walking more complex

Medical treatment for talonavicular joint pain

  • Adaptation of professional and/ or sporting activities
  • The use of anti-inflammatories radio-guided injection of corticosteroid into the affected joint
  • The use of plantar orthosis to limit joint work
  • The use of suitable shoes with a stretch walker-type rolling bar
  • Making a pair of custom orthopaedic shoes

If this fails, surgery will consist of a joint blockade targeting the joint or joints concerned.

The surgeon will favor the preservation of healthy or partially healthy joints. He notes the patient’s fear of having his foot very stiff after this type of intervention.

In the majority of cases, arthrodesis is aimed at the talonavicular joint whose amplitude has already significantly decreased, ultimately resulting in a reduction in pain which largely compensates for the loss of additional amplitude

Surgical techniques

Whether it is a talonavicular joint arthrodesis, this operation is complex and must always include:

A chosen and careful approach to avoid injuring the vessels, tendons, and nerves. The sharpening of joint surfaces to remove residual cartilage and obtain bone conducive to healing

The placement of graft to stimulate consolidation and maintain the joint spacing necessary to maintain ideal mechanics

Positioning in space is complex, particularly in its three-dimensional control. The foot is in the unloaded position.

The scope controls as well as the surgical experience make it more possible to optimise this position.

Fixation is achieved by screws and titanium plates designed to be well tolerated and most of the time left in place

Cast immobilization is necessary to obtain the consolidation obtained on average between the second and third postoperative month. Support will be prohibited during this period

Talonavicular arthritis

This is a wear of the cartilage of the talonavicular joint, between the talus and the navicular.

This joint is located on the dorsal and inner edge of the foot. It contributes to the adaptation and stability of the foot on unstable terrain.

It works with the subtalar and calcaneocuboid joints to form the torque of the foot. This arthritis can manifest itself by episodes of swelling of the rear of the foot and ankle, by sensation of blockage 

Particularly upon waking up, by pain that gradually appears when walking (particularly on unstable ground), and by partial or even total loss of mobility of the joints. The foot can become misaligned in relation to the angle.

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Talocalcaneonavicular  joint: compound joint of the enarthrosis type

The joint cavity is formed, from the inside out, by the posterior surface of the navicular bone, the upper surface of the inferior talonavicular ligament, and the upper surface of the sustentaculum tali of the calcaneus.

Each of the three parts of this cavity responds to one of the three anterior articular facets of the head of the talus.

This joint is therefore made up of three continuous parts. The anterior talocalcaneal joint, the Talo glenoid joint, and the talonavicular joint.

Navicular bone: an essential bone around the talonavicular joint

Position: The navicular bone is a tarsal bone. The latter is one of the parts of the skeleton of the foot

The tarsus is the part located at the back of the foot and is made up of 7 bones:

The talus, the calcaneus, the cuboid bone, the three cuneiform bones and the navicular bone 

Structure: The navicular bone, also called the tarsal scaphoid, is a flattened boat-shaped bone. Placed towards the medial side. It is located between the talus at the back and the three cuneiform bones at the front.

On its media side, the navicular bone forms a bulge, called the navicular tuberosity of the scaphoid tubercle 

foot ankle: pivotal part of the talonavicular joint

The segment of the lower limb which joins the leg to the foot is formed by the tibiotarsal joint and the tissues which surrounded

The ankle is formed by three bones: the internal Lower end of the tibia) and external (Lower end of the fibula)

The malleolus end of the talus  (foot bones ), rests on the calcaneus.

The Achilles tendon is located on the back of the ankle

The ankle joint allows for flexions, extension, and very slight lateral movement

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Conclusion

Make sure that you have been offered an appointment 15 days after the procedure at the hospital dispensary.

During this consultation, the wires or Staples will be removed, this scar checked and the cast changed.

An appointment to carry out a scan through the cast will be organized by you before the second consultation.

This is the only way to evaluate the consolidation of the operated area and to determine if the cast can be removed and rehabilitation started 

It is during the second visit that this scan will be analyzed by your surgeon. It is not uncommon for consolidation not to be complete and a control scan of the treated talonavicular joint will be necessary 3 to 4 weeks later.

What type of pain are you actually experiencing around these joints or do you know anyone who has experienced this in such a way? follow this appropriate step and we hope you will visit your care, provider for a proper evaluation.

Written by

Donaldson Thomas

Dr. Donaldson Thomas is a board-certified orthopedic surgeon with over 15 years of experience treating patients with musculoskeletal injuries and conditions. He completed his medical degree at Johns Hopkins University, followed by an orthopedic residency at the Hospital for Special Surgery in New York.

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