Midfoot Osteoarthritis
What is Midfoot Osteoarthritis?
Midfoot osteoarthritis involves the progressive wearing of cartilage in the joints of the arch (tarsal bones), leading to pain, stiffness, and reduced mobility.
- Often due to trauma or degenerative changes over time
- Can significantly affect walking and weight-bearing
Overview of the Condition
Midfoot arthritis can occur in the tarsometatarsal or other midfoot joints. Joint degeneration leads to pain, bony spurs, and difficulty with daily activities requiring foot flexion.
Symptoms
- Deep ache or soreness in the midfoot
- Worsening pain with prolonged standing or walking
- Swelling and stiffness in the arch area
Causes
Post-traumatic arthritis after foot fractures, degenerative changes from overuse, or inflammatory conditions like rheumatoid arthritis can damage midfoot cartilage.
Diagnosis
Clinical exam includes palpation of joints and gait analysis. Weight-bearing X-rays reveal joint space narrowing and osteophytes. MRI clarifies soft tissue and cartilage integrity.
Treatment Options
- NSAIDs, topical analgesics
- Supportive footwear, orthotics
- Activity modification
- Steroid or viscosupplementation injections
Conservative Management
Initial therapy involves reducing inflammation, using orthoses to support the arch, and altering activities to limit repetitive midfoot stress.
Rehabilitation Exercises
- Range-of-motion exercises for foot flexibility
- Toe and foot strengthening to stabilize joints
- Low-impact exercise like swimming or cycling
When is Surgery Needed?
Surgery is considered if pain severely limits quality of life and conservative treatments fail. Options vary based on the extent and location of arthritic changes.
Surgical Procedures
- Arthrodesis (fusion) of affected joints
- Arthroscopic debridement for mild cases
- Osteotomies or midfoot reconstruction if deformity exists
Anatomy Overview
The midfoot includes the cuneiforms, cuboid, and bases of the metatarsals. These joints bear and distribute body weight during gait. Degeneration here impacts arch stability.
Affected Areas
- Tarsometatarsal joints (Lisfranc joint complex)
- Naviculocuneiform joints
- Associated ligaments and joint capsule
Frequently Asked Questions
| Question | Answer |
|---|---|
| Will fusion of the midfoot affect my mobility? | Yes, fusion reduces joint motion but often relieves significant pain and improves overall function. |
| Is osteoarthritis in the midfoot common? | It’s less common than ankle or big toe arthritis, but frequently occurs after trauma or in those with abnormal foot mechanics. |
Prevention Strategies
- Protect feet from high-impact injuries
- Maintain a healthy weight
- Use supportive shoes or orthotics if predisposed to midfoot issues