Review of the evidence: Surgical management of 4th and 5th tarsometatarsal joint osteoarthritis

Russell, David F.; Ferdinand, R. D.

doi:10.1016/j.fas.2013.06.002

Cited by 17 publications

(11 citation statements)

References 33 publications

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“…Although the four selected joints can be reliably scored and used to represent midfoot OA, this present analysis pertains only to the identification of radiographic OA in the medial midfoot. Whilst clinically the occurrence of OA in the lateral midfoot is understood to be rare by comparison 48 , osteoarthritic changes in other midfoot joints could also contribute to symptoms in both midfoot pain and symptomatic midfoot OA groups. Furthermore, an alternative reference standard such as magnetic resonance imaging (MRI) or ultrasound may have generated different results and future studies could consider comparing the use of other imaging modalities for the foot.…”

Section: Discussionmentioning

confidence: 99%

Clinical diagnosis of symptomatic midfoot osteoarthritis: cross-sectional findings from the Clinical Assessment Study of the Foot

Thomas

Roddy

Rathod

et al. 2015

Osteoarthritis and Cartilage

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SummaryObjectiveTo derive a multivariable diagnostic model for symptomatic midfoot osteoarthritis (OA).MethodsInformation on potential risk factors and clinical manifestations of symptomatic midfoot OA was collected using a health survey and standardised clinical examination of a population-based sample of 274 adults aged ≥50 years with midfoot pain. Following univariable analysis, random intercept multi-level logistic regression modelling that accounted for clustered data was used to identify the presence of midfoot OA independently scored on plain radiographs (dorso-plantar and lateral views), and defined as a score of ≥2 for osteophytes or joint space narrowing in at least one of four joints (first and second cuneometatarsal, navicular-first cuneiform and talonavicular joints). Model performance was summarised using the calibration slope and area under the curve (AUC). Internal validation and sensitivity analyses explored model over-fitting and certain assumptions.ResultsCompared to persons with midfoot pain only, symptomatic midfoot OA was associated with measures of static foot posture and range-of-motion at subtalar and ankle joints. Arch Index was the only retained clinical variable in a model containing age, gender and body mass index. The final model was poorly calibrated (calibration slope, 0.64, 95% CI: 0.39, 0.89) and discrimination was fair-to-poor (AUC, 0.64, 95% CI: 0.58, 0.70). Final model sensitivity and specificity were 29.9% (95% CI: 22.7, 38.0) and 87.5% (95% CI: 82.9, 91.3), respectively. Bootstrapping revealed the model to be over-optimistic and performance was not improved using continuous predictors.ConclusionsBrief clinical assessments provided only marginal information for identifying the presence of radiographic midfoot OA among community-dwelling persons with midfoot pain.

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Section: Discussionmentioning

confidence: 99%

Clinical diagnosis of symptomatic midfoot osteoarthritis: cross-sectional findings from the Clinical Assessment Study of the Foot

Thomas

Roddy

Rathod

et al. 2015

Osteoarthritis and Cartilage

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“…12 Inclusion of the lateral column is not recommended for routine tarsometatarsal arthrodesis. 2,4,5,7 Fusion of the lateral column is indicated only if a degenerative change is present in the lateral column associated with rigid positional deformity and pain. 2,4 If lateral column fusion is indicated, it can be performed through the P34 and lateral portals.…”

Section: Discussionmentioning

confidence: 99%

“…2,4,5,7 Fusion of the lateral column is indicated only if a degenerative change is present in the lateral column associated with rigid positional deformity and pain. 2,4 If lateral column fusion is indicated, it can be performed through the P34 and lateral portals. Besides the medial and lateral portals, the other 4 portals are junction portals with the capability of approaching the adjacent articulation.…”

Section: Discussionmentioning

confidence: 99%

“…3 When conservative management is not sufficient to relieve pain, tarsometatarsal arthrodesis is indicated. 4 The goal of fusion is to alleviate pain and create a foot structure that will restore the patient's normal functional capabilities. 4 Classically, this in performed as an open procedure with extensive incisions and soft tissue dissection.…”

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confidence: 99%

“…4 The goal of fusion is to alleviate pain and create a foot structure that will restore the patient's normal functional capabilities. 4 Classically, this in performed as an open procedure with extensive incisions and soft tissue dissection. [1][2][3]5,6 The purpose of this technical note is to describe a minimally invasive approach of arthroscopic arthrodesis of the involved tarsometatarsal joints (Table 1).…”

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confidence: 99%

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Arthroscopic Tarsometatarsal Arthrodesis

Lui¹

2016

Arthroscopy Techniques

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Tarsometatarsal (Lisfranc) osteoarthritis can be a disabling condition and is commonly due to posttraumatic causes. Tarsometatarsal arthrodesis is indicated if the pain does not subdue with conservative treatment. Classically, this is performed as an open procedure. The purpose of this technical note is to describe a minimally invasive approach of arthroscopic arthrodesis of the involved tarsometatarsal joints. The arthroscopic procedure is performed through the junction portals of the involved articulation. It has the advantages of better cosmesis, less wound complication, less bone resection, and more thorough joint debridement. However, it is contraindicated if there is an associated significant foot deformity or shortening of the involved foot rays.T he tarsometatarsal (Lisfranc) joint has 3 columns. The medial column consists of the first metatarsocuneiform joint. The middle column consists of the second and third metatarsocuneiform joints. The lateral column consists of the fourth and fifth metatarsocuboid joints.

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Midfoot Arthritis

Hood¹

2020

Evidence-Based Podiatry

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Review of the evidence: Surgical management of 4th and 5th tarsometatarsal joint osteoarthritis

Cited by 17 publications

References 33 publications

Clinical diagnosis of symptomatic midfoot osteoarthritis: cross-sectional findings from the Clinical Assessment Study of the Foot

Clinical diagnosis of symptomatic midfoot osteoarthritis: cross-sectional findings from the Clinical Assessment Study of the Foot

Arthroscopic Tarsometatarsal Arthrodesis

Midfoot Arthritis

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