Kohler Disease

Kohler disease is a relatively uncommon condition where the blood supply to the navicular bone in the foot is greatly impaired or lost. This is known as avascular necrosis, and causes tissue death through the insufficient blood (and oxygen) supply. Kohler disease most often affects children from the age of 5 years onward, though can present in children as early as 2 years old and again in adulthood. It has a greater prevalence in boys than girls.  

What causes Kohler disease?

While the exact reason for the loss of blood supply to the navicular is unknown, it is thought to be linked to:

• Compression and excess stress on the naviuclar bone during growth
• Genetic predisposition
• Vascular abnormalities
• Bony abnormalities

 

What are the symptoms?

Symptoms can last from days to up to two years, and may include:

• Pain and tenderness in the area of the navicular of the inside of the foot and arch
• Redness and swelling
• Limping or avoiding weight bearing on the inside of the affected foot

 

How is it treated?

While symptoms can resolve on their own, Kohler’s can produce significant pain in the meantime and make it difficult to walk. Your podiatrist will work with your GP to effectively manage this condition and may obtain radiographs to examine the state of the navicular bone. To help resolve painful symptoms, this may include the use of:

• Orthotics to help support the navicular and arch and reduce compressive forces acting on the affected area
• Brace, boot or cast to immobilise the area
• Footwear assessment to ensure that the shoes are helping and not hindering recovery

The outcome of Kohler disease is usually excellent, often with no long-term complications or damage.