Accessory Navicular Removal

What Is Accessory Navicular Removal?

Accessory Navicular removal is the surgery performed to remove the Accessory Navicular bone. The Kidner procedure is the most common procedure performed for the removal of this bone.

It is considered as an option only when non-operative conservative treatment techniques have yielded unsatisfactory results in providing sufficient pain relief. 
The outcome of this procedure is generally good.

What Conditions Does Accessory Navicular Removal Help?

Accessory Navicular removal is required in cases of Accessory Navicular syndrome. 

Why Is Accessory Navicular Removal Required?

This procedure is required when the inflammation and pain caused by the Accessory Navicular bone is unresponsive to conservative treatment options, thus requiring surgical intervention to provide relief to the patient.

Who Is Accessory Navicular Removal Suitable For?

Accessory Navicular removal surgery is suitable for most individuals.

However, people who are suffering from a lung or a heart condition or chronic disease such as diabetes are evaluated on a case by case basis before being considered eligible for this procedure.

Treatment Process

Preparation for Surgery

  • Requires preoperative medical evaluation consisting of a complete patient history and physical examination to determine suitability for the procedure, which may also include lab tests and X-Ray imaging.
  • The surgeon also determines between the different surgical procedure options on a case by case basis, based on the severity of the bursa formation, patient’s health and lifestyle. 
  • Adequate counsel is needed to ensure that the informed consent obtained is fully understood.
  • Use of any anti-inflammatory medications (NSAIDs) should be stopped at least seven days before the procedure.

Day of Surgery

  • Report any infections to me prior to surgery as the procedure cannot be performed until all infections have cleared up.
  • Do not consume alcohol - 24 hours prior to treatment,
  • Do not eat or drink anything, including water, for 6 hours before surgery
  • Avoid vigorous physical activity or exercise 24 hours prior to surgery,
  • Procedure options include:
    • The Kidner procedure where the posterior tibialis tendon is detached and reattached, or
    • Modified Kidner procedure where the posterior tibialis tendon is not detached.

During Surgery

  • Administration of general anesthesia
  • The entire procedure can take two to three hours
  • Procedure is performed and sent to recovery room, for observation
  • Making the individual comfortable in the surgical suite
  • Identification of the proper limb and joint and surgical draping
  • Administration of general anesthesia
  • Surgical incision over the Accessory Navicular bone
  • Complete removal of the Accessory Navicular bone
  • Reattachment of the tibial tendon
  • Closing the incision with stitches, and recovery from the anesthesia
  • Pain medications are prescribed to help with pain during the recovery phase

After Surgery

  • Immediately after the procedure, the patient is moved to the recovery room, where he is kept under observation until they regain consciousness where general anesthesia is used.
  • Pain medications are prescribed to help with pain during the recovery phase.
  • Do not consume large amounts of alcohol after surgery,
  • Avoid vigorous physical activity or exercise until advised,
  • Follow the Post Surgery Treatment Plan proscribed by the surgeon and post op care specialists.
  • Any questions or complications should be communicated directly to the surgeon

Common Questions

If you have a specific question about your treatment, we recommend contacting the practice.
  • Hospital Discharge?

    The patient is then discharged from the hospital in a day or two after the procedure. 


    The patient is advised on the steps to keep the wound dry and clean and on scar management.


    The patient is also advised to 

    • maintain a strict elevation of the joint for ten days. 
    • arrange help to assist with chores, and
    • avoid putting any weight on the joint, with the help of crutches and walkers.
  • Recovery After Accessory Navicular Removal?

    Even minor injuries can have a prolonged recovery period. 


    Patients are normally immobilised in a below-knee cast or boot for 6 weeks.


    Other conditions include:

    • no weight-bearing during this time, and 
    • often a further 4-6 weeks in a boot is required once walking is started. 

    Return to maximum function often takes up to one year after the injury.

  • Wound Management?

    At the time of discharge patients are advised on:

    • The necessary steps to keep the wound dry,
    • Wound care and Cleaning, and 
    • On scar management. precautions.
  • What if I Am Pregnant?

    It is not recommend surgery while pregnant, as the risks are uncertain due to the lack of information available about the effect on the fetus. 


    For more information please call us on and request to speak with one of our medically-trained registered doctor or nurse.

  • Post Surgery Treatment Program

    Long term outcomes depend on the severity of the initial injury. 


    Some patients won’t get back to their pre-injury function or sport, even with well-performed surgery. 


    Ten Days After Surgery

    X-rays are repeated ten days after the procedure to determine the situation. 


    Physiotherapy

    For the best possible outcome, postoperative physical therapy plays an important role in proper recovery following your procedure. 


    This postoperative management includes regular scheduled visits with a physical therapist 


    Extended Recovery Period

    The patient is advised to limit their activities for six to eight weeks after the surgery.


    Certain activities such as driving are also restricted for up to six weeks post-surgery. 

  • Possible Risks or Side Effects?

    The procedure carries all the risks associated with surgery, such as 

    • infection, 
    • bleeding and 
    • a severe allergic reaction to anesthesia. 

    Redness and bruising at the site of injection may be seen which should resolve over time. 


    You may experience post operative pain for prolonged period or other serious side effects contact your surgeon, as well as:

    • damage to the structures around the operative zone such as nerves, blood vessels, tendons, muscles,
    • chronic pain due to nerve entrapment
    • delayed healing
    • wound infection or breakdown.

    There is also a risk of nerve injury or chronic pain if the post-operative steps to ensure proper healing are not followed by the patient.

  • Possible Complications of Surgery?

    If this condition or injury is missed or untreated can result in the collapse of the arch of the midfoot with significant pain, and the development of arthritis. 


    When surgery is performed, risks include damage to the structures around the top of the foot (nerves, blood vessels, tendons, muscles), as well as a risk of wound infection or breakdown.


    It is common to sustain cartilage damage at the joint surfaces during the initial injury, and some people develop midfoot arthritis and ongoing pain down the track. 


    Some patients require further surgery to fuse the midfoot joints to relieve arthritis pain.

  • Do You Offer Discounts?

    Due to strict regulations set by the Australian Medical Board it is against the law to offer surgical inducements. 


    Discounted treatments should raise alarm bells when you are choosing which specialist to trust your treatment to. 


    The surgeon's skill is more important than price. Effective surgery will maximise your health outcome.