School of Podiatric Medicine - Student Research

Document Type

Poster

Publication Date

Spring 4-26-2026

Abstract

The aim of this study is to determine the efficacy and safety profile of total navicular implants based on current literature.

Navicular insults such as high-energy trauma, osteonecrosis, and Muller-Weiss syndrome may result in avascular necrosis or a critical sized bone defect, conditions that are highly difficult to manage given current treatment modalities. Total navicular implants may offer a solution to these problems. While 3D printing of implants remains investigational, its use in highly individualized cases involving the talus has had promising results with conditions like avascular necrosis, tumors, trauma, and arthritis. The navicular is unique in its attachments to the tibialis posterior, spring ligament, and deltoid and thus its critical role in the biomechanics of the foot – as supported by the landmark Astion article, which demonstrated that 91% of subtalar joint motion would be restricted when the talonavicular joint is fused. With Total Navicular implants, it may be possible to preserve the range of motion of the talonavicular joint and reduce pain in appropriate pathology presentations.

Investigators searched PubMed, Cochrane, Web of Science, and Google Scholar for candidate articles for “Total Navicular”. Parameters were set for articles that would be included in the study and documented using a PRISMA flow chart. Exclusion criteria included: duplicates, paper not available in English, paper does not pertain to Total Navicular Implant, not being original research, and full text not available.

Systematic search yielded twenty-five total results among all the databases. Of these twenty-five results, only three papers fit the parameters. There were three documented cases for Total Naviculars within these papers. The indications for the Total Navicular implants were one chronic diastasis Navicular fracture, and two osteonecrosis of the Navicular. Two of the three implants were made with Titanium of these implants, one was coated with nitrate coating. The third paper did not record what material was used to create the implant. Additional procedures that done with a Total Navicular were Total Talus, Total Cuboid, and Posterior Tibialis allograft extension. One implant was fused to all three cuneiforms, one implant was fused to the talus, and one implant was incorporated with a Total Talus. Follow up of the patients ranged from no recorded follow up, 2.5 years, and 4 years. Patients were evaluated with short form survey, foot and ankle disability index, and VAS pain score which had improved greatly since the surgeries.

The findings suggest that Total Navicular implants in Navicular osteonecrosis have a promising success rate; however, there is a lack of follow-up to demonstrate the viability of Total Navicular implants as a long-term treatment. There are also no long-term studies of total navicular implants used in other pathologies such as Charcot, rheumatoid arthritis, and tumors – that may expand current indications for this treatment modality. Further research is required to determine the viability of Total Navicular Implants.

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