Midfoot Arthritis

  What is midfoot arthritis?

Midfoot arthritis occurs when one or more of the joints in the middle of the foot become worn or damaged.

It can develop through normal wear and tear, following an injury or fracture, because of abnormal foot mechanics or as part of inflammatory arthritis.

What symptoms and signs might I experience?

• Pain across the middle or top of the foot.
• Stiffness.
• Swelling.
• Pain when walking.
• Pain when pushing off.
• Pain on uneven ground.
• A bony prominence on the top of the foot.
• Difficulty wearing shoes.
• Reduced walking distance.

How is it diagnosed?

Diagnosis usually involves examination and weight-bearing X-rays.

A CT scan may occasionally be useful to assess the joints in greater detail, particularly before fusion surgery.

An injection into an individual joint can sometimes help confirm which joint is responsible for the pain.

How is it treated without surgery?

Treatment may include:

• Stiff-soled footwear.
• Rocker-bottom shoes.
• Orthotics.
• Activity modification.
• Physiotherapy.
• Pain relief or anti-inflammatory medication.
• Weight management where appropriate.
• Injection into the affected joint.

When might surgery be considered?

Surgery may be considered when pain remains significant despite appropriate treatment and affects walking or quality of life.

What might surgery involve?

The most common operation is midfoot fusion.

The damaged joint surfaces are removed and the bones are fixed together until they heal as one bone.

Not every arthritic joint necessarily needs to be fused. Surgery is targeted at the joints that are responsible for the symptoms.

What is recovery like?

Fusion requires time for the bones to heal. You will usually need a period of protected or non weight-bearing for 6 weeks followed by gradual rehabilitation.

Full recovery can take several months.