The midfoot refers to the section of the foot that begins at the level of the Chopart joint. You cannot feel this joint but it is made up of 2 joints in line, just below and in front of the ankle joint. The midfoot ends at the Lisfranc joint or tarsometatarsal joint, where the metatarsal bones begin.
The midfoot contains 5 bones which are connected by “joints” to one another and also these 5 bones are connected to the “hindfoot” and “forefoot” by other joints.
The bones are called:
Classically midfoot arthritis describes arthritis at the level of the Lisfranc joint but can involve arthritis between the cuneiform and the cuboid and navicular bones.
There are different reasons for developing arthritis in the small joints in the midfoot.
The clinical features as discussed above in addition to typical X-Ray findings seen, can confirm the diagnosis. Further scans are usually unnecessary, but some surgeons will arrange a CT scan to exactly identify the joints involved.
People often “live” with the symptoms for many years and then finally seek medical attention. If you decide not to see your doctor, the problem will tend to progress, usually slowly. Stiffness will usually increase and the pain can get worse making walking gradually more difficult and weight bearing exercise difficult. The condition can be treated at any stage but as it develops, more nearby joints can become affected.
The treatment can involve a combination of different therapies below:
Surgery can simply involve removing any bony prominences on the top of the foot but usually necessitates formal stiffening procedure or a midfoot fusion of the small painful joints. This is a great operation because the joints are already stiff but “painful” and the operation can make them stiff but “painless”.
Many patients are simply seeking advice on managing a problem. In mild cases modifying shoes or activities can prove a successful therapy however if non-operative measures have failed to improve symptoms then surgery is indicated, but the timing of the surgery can be arranged to suit your needs. As said earlier, even if the condition worsens, surgery is always an option, but the exact surgical procedure performed may differ slightly from the original surgery possible and may be more technically challenging.