Medial Naviculocuneiform Arthritis Associated With Central Tarsometatarsal Arthritis: Case Series of a Distinct Midfoot Arthritis Pattern.

Abstract

Midfoot arthritis affects patient function and can cause notable pain. We describe a distinct pattern of midfoot arthritis in patients without known trauma or underlying medical diagnosis. Patients were identified from clinical practice as having radiographic arthritis involving the medial naviculocuneiform and central tarsometatarsal joints, without a history of trauma. Medical records were reviewed to examine demographic data, bilaterality, treatment, and surgical outcomes (if applicable). Forty-one patients were identified as having this pattern of midfoot arthritis. Ninety-eight percentage of patients in this cohort were female. Bilaterality was observed in 63% of patients with bilateral radiographs available for comparison. Seventy-seven percentage of patients who underwent fluoroscopic injection into their medial navicular cuneiform joint and central tarsometatarsal joints experienced notable improvement in symptoms (and did not undergo surgical intervention during the study time frame). Among patients who underwent surgery (n = 10), the union rate was 78% (five/nine patients, one patient lost to follow-up). Surgical patients had an average of 2.2 (range of 0 to 5) fluoroscopically guided injections before surgery. This report educates practitioners on a distinct pattern of midfoot arthritis. This pattern of midfoot arthritis seems to respond favorably with fluoroscopically guided injections into the medial cuneiform joint and/or the central tarsometatarsal joints. Only a subset of patients required midfoot arthrodesis.