Accessory navicular is when there is an extra bone adjacent to the navicular and within the posterior tibial tendon that attaches to the navicular. Some patient’s will see an out pocketing on the inside portion of their foot. The tibialis posterior tendon is the primary tendon that holds up the arch and when it doesn’t attach directly into the navicular it can’t do it’s job efficiently. This will lead to pain, swelling, tenderness or a decease in the height of the arch.
Initial treatment for a painful accessory navicular is non-operative. Patients are instructed to start wearing supportive shoes, inserts/orthotics, icing, anti-inflammatories and to perform stretching exercises. Conservative care is very successful in alleviating pain associated with an accessory navicular, however when pain continues its time consider surgery. Dr. Gold or Dr. Schoenhaus would remove the extra bone within the tendon and then sometimes re-attach the tibiais posterior tendon to the navicular. The procedure is called a Kidner procedure. It’s a relatively simple surgery with a brief rehabilitation period and a very good success rate.