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Midfoot Arthritis

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Evidence-Based Podiatry

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Abstract

Midfoot arthritis consists of a degenerative process across the tarsometatarsal joint with the potential inclusion of the intercuneiform and naviculocuneiform joints. Breakdown to this area is most commonly post-traumatic in origin, often secondary to a LisFranc complex injury whether ligamentous, osseous, or combined. Secondary causes include osteoarthritis, inflammatory arthropathies, and Charcot neuroarthropathy. The midfoot functions as a three column system with a more rigid medial and middle column and flexible lateral column. When functioning in tandem with the leg and hindfoot, the three columns produce efficient gait through their innate motion and biomechanics. As this area breaks down, gait becomes dysfunctional, and the foot becomes painful with the potential for degeneration and deformity. Conservative treatment options attempt to manage symptoms and support the foot through anti-inflammatory medications, injections, shoe and orthotic modification, and physical therapy. There are many surgical options from simple exostectomy and individual column arthroplasty, to the gold standard of midfoot fusion with or without deformity correction. One controversy in fusion includes the debate of whether to include the mobile lateral column in a fusion or preserve motion through arthroplasty or no procedure at all. Here, a full work up of midfoot arthritis is presented with guidance in forming a treatment plan.

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Authors and Affiliations

  1. Hunterdon Podiatric Medicine, Hunterdon Healthcare System, Flemington, NJ, USA

    Christopher R. Hood Jr

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  1. Christopher R. Hood Jr
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Correspondence to Christopher R. Hood Jr .

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  1. American Podiatric Medical Association, Bethesda, MD, USA

    Dyane E. Tower

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Hood, C.R. (2020). Midfoot Arthritis. In: Tower, D.E. (eds) Evidence-Based Podiatry. Springer, Cham. https://doi.org/10.1007/978-3-030-50853-1_6

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  • DOI: https://doi.org/10.1007/978-3-030-50853-1_6

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