Midfoot arthritis: evaluation and treatment, surgical and nonsurgical

Abstract

Purpose of review Midfoot arthritis is a relatively common problem with multiple etiologies. Several nonsurgical treatments are available that may provide symptomatic relief and delay the need for surgical intervention. Many surgical options also exist for the treatment of midfoot arthritis, and recent advances in treatment are discussed in this article. Recent findings Arthrodesis remains the gold standard for the treatment of arthritis at the metatarsal cuneiform articulations. Arthrodesis accelerates the development of arthrosis in the remaining joints, and in the more mobile joints of the lateral column, at least theoretically, gives cause for concern. Patients considered for fusion of the fourth and fifth tarsometatarsal joints include those with intractable painful lateral column arthritis that is recalcitrant to non-surgical management. Encouraging medium-term results have been described in the recent literature regarding interposition arthroplasty of the fourth and fifth tarsometatarsal joints. Current literature shows excellent results with ceramic interpositional arthroplasty over a relatively short period and presents a promising treatment option. Summary A wide variety of surgical and non-surgical treatment options currently exist for midfoot arthritis. Less invasive and motion-preserving procedures are gaining popularity. Arthrodesis remains the primary surgical treatment for most.