Summary

SIMULTANEOUS BILATERAL SURGERY FOR ACCESSORY NAVICULARS DOES NOT HAVE A NEGATIVE EFFECT ON POSTOPERATIVE OUTCOMES

Abstract

Background

Accessory navicular tends to occur bilaterally; however, unilateral surgery is performed more often than simultaneous bilateral surgery. The purpose of this study was to compare the clinical outcomes of unilateral and simultaneous bilateral surgeries.

Methods

Between 2018 and 2022, 42 feet in 26 patients underwent resection of the accessory navicular using the enucleation technique for a type-II symptomatic accessory navicular. Patients were classified into 2 groups according to unilateral (group Uni) or bilateral (group Bi) surgery. Clinical outcomes and time to postoperative walking, jogging, and return to full athletic activities were compared between the groups. The patients were followed up for a minimum of 12 months.

Results

There were 10 and 16 patients in group Uni (4 males and 6 females; mean age, 26.7±14.3 years) and group Bi (3 males and 13 females; mean age, 13.6±4.7 years), respectively. A comparison between group Uni and group Bi revealed no significant differences in the number of days until walking, jogging, or full athletic activity (P = .27, .21, and .051, respectively). There were no statistically significant differences between groups in terms of mean postoperative SAFE-Q scores for any of the subscales. To avoid the influence of age, stratified analysis was conducted by dividing the participants into those aged ≤ 16 years and those aged > 16 years. No statistically significant differences were observed between the group Uni and group Bi. Similar results were also observed in the t-test. In addition, we conducted a similar analysis by changing the age cutoff to 15 or 19 years, but no qualitative changes were observed in the results.

Conclusion

There is no clear evidence that bilateral surgery for type-II symptomatic bilateral accessory navicular delays recovery, and there is no need to avoid bilateral simultaneous surgery, regardless of age.