Midterm Outcome of Modified Kidner Procedure

Abstract

Background: The results of modified Kidner procedures have generally been satisfactory at short-term followup. The objective of this study was to evaluate the midterm followup results including medial longitudinal arch height. Methods: Forty-one patients (50 feet) with a symptomatic accessory navicular who underwent the modified Kidner procedure between July 1999 and December 2004 were evaluated. A midfoot AOFAS score, VAS score, and satisfaction rate were recorded. The talo-first metatarsal (T-MT1), talo-calcaneal (TC), and calcaneal pitch (CP) angles were measured on plain radiographs. Average clinical and radiological followup periods were 88.4 ± 17.0 months and 85.7 ± 15.0 months, respectively. Results: The mean preoperative and followup AOFAS scores were 40.8 ± 7.1 (range, 32 to 57), and 88.4 ± 7.9 (range, 72 to 100), respectively ( p < 0.01). The mean preoperative and followup VAS scores were 7.1 ± 1.0 (range, 4 to 9) and 1.8 ± 1.0 (range, 0 to 5), respectively ( p < 0.01). At last followup, the satisfaction rate was 82.0%. There were no significant differences between preoperative and followup T-MT1 ( p = 1.00), TC ( p = 0.84), and CP ( p = 0.08) angles. Increased medial longitudinal arch was found in four of 16 feet in patients 15 years of age or younger with followup radiographs. Conclusion: We found the modified Kidner procedure could result in symptomatic relief and high satisfaction rate without a loss of arch height in any patient. Level of Evidence: IV, Retrospective Case Series