Outcome of talonavicular arthritis treated with platelet rich plasma injection: a case report

Abstract

Osteoarthritis of the talonavicular (TN) joint, which can result from inflammatory, degenerative, or post-traumatic arthritis, is frequently reported. TN arthritis causes pain, swelling, and stiffness in the joint. Early diagnosis is crucial, typically using X-rays, computed tomography (CT) scans, or magnetic resonance imaging (MRIs) to detect joint damage. Treatment often involves pain relievers and non-steroidal anti-inflammatory drugs (NSAIDs). If these methods don't provide relief, isolated fusion (arthrodesis) of the TN joint is often recommended as a treatment option. There are no published reports describing the use of platelet rich plasma (PRP) for treating TN arthritis. A 45-year-old female presented with persistent right foot pain for one year following a twisting injury. Radiographs showed joint space narrowing, osteopenia, and peripheral osteophytes at the TN joint. PRP was prepared using a two-step centrifugation process and injected under C-arm guidance into the TN joint. The patient was followed for two years and assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score, which improved from 68 to 90. No adverse events were reported. This case highlights the potential of PRP as a minimally invasive treatment option in early-stage TN arthritis. It adds to the growing evidence supporting intra-articular PRP injections for small joint osteoarthritis, as also supported by recent studies on ankle and talar cartilage degeneration. PRP may serve as a safe and effective alternative to surgery in selected patients with TN arthritis. Further research is warranted to establish standardized treatment protocols.