Tarsometatarsal Arthritis Overview
Tarsometatarsal (TMT) arthritis is a debilitating condition characterized by midfoot instability, severe functional impairment, and pain. The most common cause of midfoot arthritis is post-traumatic arthritis, followed by primary osteoarthritis and other inflammatory processes.
Tarsometatarsal Arthritis Symptoms
Swelling across the top of the midfoot region.
Palpable bump of bone.
Shooting and tingling sensation on the top of the foot while wearing closed shoes.
Progressive flattening of the arch of the foot.
The front part of the foot turns outward relative to the back part of the foot.
The difficulty with walking short distances.
Inability to participate in any sports due to pain.
Tarsometatarsal Arthritis Diagnosis
X-rays usually reveal joint space narrowing and bone spurring on the top of the midfoot region. Shifting of the bones creating abnormal bone posture is often seen in mid to late cases. Widening of bone spaces indicative of dislocation is also common.
Tarsometatarsal Arthritis Treatment
Nonsurgical options for treatment include non-steroidal anti-inflammatory drugs (NSAIDs), custom made orthotics and shoe modifications. If these methods fail to relieve symptoms to an acceptable level, surgery on the painful tarsometatarsal joints is the treatment of choice. The surgical goal is to reduce painful motion and increase the stability of the foot. This goal can be obtained through partial or total fusion of the tarsometatarsal joints. Correction of the deformity is a secondary concern. The decision to ascertain the extent of the arthrodesis should be based on the location of pain and the radiological appearance of the joints. Arthrodesis can be restricted to one joint or include multiple joints. The most common joint requiring stabilization is the first metatarso-cuneiform articulation.