Midfoot arthritis: Nonoperative Options and Decision Making for Fusion

Arthritis of the midtarsal and tarsometatarsal joints (midfoot) has emerged as a challenging problem because of its high potential for chronic foot pain and functional disability. Although the incidence of patients presenting with midfoot arthritis is increasing at an alarming rate, guidelines for clinical decision making are lacking in the literature. The primary aim of treatment is to afford pain relief by enhancing midfoot stability and modifying loads sustained at the inflamed joints. These treatment goals are attempted initially through conservative management such as orthoses followed by surgery. This manuscript discusses strategies for conservative management and details the operative techniques for tarsometatarsal fusion. In addition, outcomes after intervention are presented.