Midfoot and Tarsometatarsal Arthritis


Midfoot arthritis can be the result of several problems, including trauma, inflammatory disease, neuropathic arthropathy, and primary (idiopathic) arthritis. The most common presenting complaint in patients with midfoot arthritis is pain along the dorsum of the foot with weight bearing. Patients with midfoot arthritis may also report pain from constrictive shoe wear secondary to osteophyte formation along the dorsum of the foot. Deformity associated with midfoot arthritis can lead to a significant amount of pain independent of the arthritic symptoms. Initial treatment should consist of nonsurgical measures focused at controlling the pain and deformity. If appropriate treatment fails after 6 months, consideration must be given to surgical intervention. The gold standard for surgical treatment of midfoot arthritis is arthrodesis. Interpositional tendon arthroplasty of the fourth and fifth tarsometatarsal joints may be an acceptable motion-sparing alternative to arthrodesis in patients with lateral column arthritis.

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