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Navicular Screw impingement and removal


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#1 sprintguru100

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Posted 11 September 2019 - 08:38 PM

Hi all,

I [24M] had a navicular screw fixation about 2.5 years ago and have just managed to get back to my previous training volume. Unfortunately, been getting vague pain on impact, approximately at my lateral cuneiform. Had some x-rays done, showing that one of my screws sits high on the navicular and is impinging upon the lateral cuneiform.Surgeon wants to remove the screws and scope out the joint for debris, my main concern is that the screw tip has damaged the joint surface and that I'll end up with OA down the track. Anyone had any experiences with screw removal, rehab timelines etc. ? The surgeon seems to think I will be able to weightbear immediately and start running after 3 weeks, however, I feel this timeline is extremely optimistic.

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#2 TheRunPhysio

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Posted 14 September 2019 - 08:23 PM

I would follow the surgeons advice or if in doubt get a second surgical opinion. It very much depends on the hardwear and its location. It may not impact future OA risk (risk is already there unfortunately) but if you want to continue running and its causing impact related pain it would generally be best to get it removed. Potentially that could preserve the joint. Usually running can be progressed fairly quickly post surgery. Some surgeons may prefer to wait 4-6 weeks prior to running and we are often guided by tissue healing, strength and tolerance/pain.

#3 sprintguru100

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Posted 17 September 2019 - 07:58 PM

Thanks for the reply, had an x-ray today that suggested that joint spaces are preserved which I suppose is a positive.
Seems the pain must be coming from the screws. Will look to get them removed ASAP and may get a second opinion for the surgery, as my foot only ever returned to about 75% of its former capacity following the fixation.
Glad to hear that return to running can be progressed quite quickly.