Anatomy of the Naviculocuneiform Joint

NewsBot · Feb 3, 2022

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Anatomy of the Naviculocuneiform Joint
George J. Borrelli, MD, Mossub Qatu, MD, Christopher J. Traynor, ...
Foot & Ankle Orthopaedics January 20, 2022

Introduction/Purpose:
The naviculocuneiform (NC) joint has a role in numerous pathologies of the foot and ankle. There is little in the published literature quantifying the cartilage of the articulating surface and its unique anatomical features. The purpose of this study was to quantify and describe the articular surface of the NC joint. Our hypothesis was that the cartilage surface would have anatomic features that would guide surgeons when performing procedures such as joint preparation and screw placement.

Methods:
Twenty cadaver NC joints were dissected, and the articular cartilage quantified by calibrated digital imaging software.

Results:
The mean dorsal to plantar height of the navicular facets was 18mm, with a maximum height not exceeding 21mm. The mean height of the medial, middle, and lateral cuneiform facets was 15mm, 17mm, and 15mm, respectively. The mean length from the medial to middle navicular facet was 14mm, approximately 41.3% the mean length across all three navicular facets (34mm). For the distal navicular articulation, 75.4% of the mean surface area was articular cartilage. For the proximal medial, middle, and lateral cuneiform articulations, 69.6%, 75.7%, and 75.8% of the mean surface areas were articular cartilage, respectively.

Conclusion:
This study provides an anatomic description of the NC joint to guide surgeons when operating on the NC joint. Two clinical observations can be made from this data. First, when preparing the NC joint for arthrodesis from a dorsal approach, the surgeon should be aware that the cartilage of the NC joint can extend up to 21mm from dorsal to plantar. This is also a useful estimate of screw length in the subchondral bone. Second, the central third of the navicular, where the majority of navicular stress fractures occur, lies in the inter-facet ridge between the medial and middle facets.
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NewsBot · Apr 26, 2024 at 3:34 AM

Anatomy of the Naviculocuneiform Joint Complex
George Borrelli et al
Foot Ankle Orthop. 2024 Apr 8;9(2)

Background: The purpose of this study was to quantify the articular surfaces of the naviculocuneiform (NC) joint to help clinicians better understand common pathologies observed such as navicular stress fractures and arthrodesis nonunions.

Methods: Twenty cadaver NC joints were dissected and the articular cartilage of the navicular, medial, middle, and lateral cuneiforms were quantified by calibrated digital imaging software. Statistical analysis included calculating the mean cartilage surface area dimensions of the distal navicular and proximal cuneiform bones. Length measurements on the navicular were obtained to estimate the geographic location of the interfacet ridges. Lastly, all facets of the articular surfaces were described in regard to the shape and location of cartilaginous or fibrous components. Results were compared using Student t tests.

Results: Navicular cartilage was present over 75.4% of the surface area of the proximal NC joint, compared with 72.6% of combined cuneiform cartilage distally. The mean height of the deepest (dorsal-plantar) measurement of navicular articular cartilage was 18 ± 3 mm. The mean heights of the distal medial, middle, and lateral cuneiform articular facets were 15 ± 1 mm, 17 ± 2 mm, and 15 ± 2 mm, respectively.

Conclusion: There is significant variation among the articular surfaces of the NC joint. Additionally, the central third of the navicular was calculated to lie in the inter-facet ridge between the medial and middle articular facets of the navicular.

Clinical relevance: Surgeons may consider this study data when performing joint preparation for NC arthrodesis as cartilage was present to a mean depth of 18 mm at the NC joint. Additionally, this study demonstrates that the central third of the navicular, where most navicular stress fractures occur, lies in the interfacet ridge between the medial and middle articular facets of the navicular.
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