Prognosticators for Failure of Nonoperative Treatment in Müller-Weiss Disease: The Thai Experience.

Abstract

Literature on nonoperative treatment of Müller-Weiss disease (MWD) is limited. Reliant upon mechanical offloading using orthotics, it aims to relieve symptoms without permanent disease correction. Success ranges from 58% to 80%. Identifiable descriptive factors prognosticating its failure are midfoot abduction with anteroposterior talo-first metatarsal angles exceeding 13° and radiographic talonavicular joint arthritis. Patients should be informed of these important facts before initiating treatment to ensure realistic expectations and effective compliance. Future research with larger samples and better recruitment criteria are necessary to clearly define factors that would point toward failure or success rate of conservative treatment in MWD.