Midfoot Arthritis

The midfoot includes the tarsometatarsal and naviculocuneiform joints. It contributes to the normal arch of the foot and helps with walking. If arthritis is present, there will be damage or degenerative changes to the joint cartilage which can become thin and eventually allow bone-on-bone contact.

Symptoms of midfoot arthritis

Middfoot arthritis causes pain, swelling and stiffness that is most noticeable when walking or running. It may affect both feet.

  • Pain especially with activity and push off
  • Pain particularly first thing in the morning
  • Progressive stiffness and difficulty walking on uneven ground
  • Swelling
  • Fallen arch
  • Difficulty with shoe wear
Causes of midfoot arthritis

  • Primary osteoarthritis with articular cartilage damage
  • Secondary osteoarthritis: related to trauma or previous fractures such as LisFranc fracture / dislocations, or increased joint stress from adjacent joint disease
  • Inflammatory arthropathy; most commonly rheumatoid arthritis
  • Charcot neuroarthropathy
Imaging for midfoot arthritis

  • Weight-bearing X-rays are required with additional views
  • Occasionally CT scans are required
Non operative treatment for midfoot arthritis

  • Topical pain creams e.g. NSAIDS
  • Pain medications e.g. NSAIDS such as Mobic or Panadol Osteo
  • Shoe wear modification
    • stiffer soled shoe with rocker bottom modification
  • Activity modification:
    • improve fitness and strength via non axial loading exercises e.g. cycling, swimming
    • avoid axial loading exercises e.g. running
  • Weight loss management
  • Joint injections may help with pain management and differentiation of which joints are the main problem
Surgery for midfoot arthritis

  • Lisfranc injury surgery
  • Open fusion

  • Open fusion in combination with
    • realignment procedures of the midfoot
    • hind foot surgery
    • Achilles tendon lengthening

Midfoot Fusion

Post-operative guide by Dr Danielle Wadley

Risks of midfoot arthritis surgery

All surgery has risks involved, however every effort is made to reduce these risks. Risks include but are not limited to:

  • Infection: superficial wounds or deep infections
  • Clots: DVT (deep venous thrombosis) or PE (pulmonary embolus)
  • Nerve damage: tingling, numbness or burning
  • Ongoing pain
  • Stiffness of the ankle joint
  • General or anaesthetic risks including to the heart and lung
  • Drug reactions/allergy
  • Scarring or tethering of the skin
  • Nonunion (bones do not fuse adequately)
  • Calf weakness
  • Revision surgery

There are increased risks of surgery in diabetics, smokers, significant peripheral vascular disease, severe neuropathy, previous or current infection which may preclude a patient from surgery.

View FootForward for Diabetes (run by Diabetes Australia) for more information on foot care.  

For all appointments and enquiries, please phone 07 5645 6913 or email info@salusfootsurgeon.com.au

9 Kinloch Avenue
Benowa QLD 4217


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