Midfoot osteoarthritis
Understanding this condition
The midfoot is the central part of the foot, located between the hindfoot (heel) and the forefoot (metatarsals and toes). It includes two main joints: the Chopart joint (between the hindfoot and midfoot) and the Lisfranc joint (between the midfoot and forefoot). These joints transmit forces with every step and participate in the foot's adaptation to the ground.
Midfoot osteoarthritis is cartilage wear of one or more of these joints, most often at the Lisfranc level. It can be primary (age-related) or secondary to an old injury often overlooked (an unnoticed Lisfranc sprain), a static foot disorder (flat foot, cavus foot), or an inflammatory disease.
Symptoms
Pain on the top of the foot, in its middle portion, when walking and weight-bearing. Aggravated by prolonged standing and uneven terrain.
A bony prominence may appear on the top of the foot (rubbing with footwear). Progressive midfoot stiffness.
How can it progress?
Lisfranc osteoarthritis progresses slowly but steadily. Pain intensifies, walking distance shortens, and the foot may flatten (loss of the longitudinal arch).
In the long term, functional impairment becomes significant.
Treatment options
First line: orthopaedic insoles with arch support, appropriate footwear (rigid or semi-rigid soles), analgesics, injections.
When medical treatment is no longer sufficient, Lisfranc arthrodesis (fusion of the worn joint) permanently eliminates pain by sacrificing a range of motion that has in any case become minimal. A consultation helps assess the right time for surgery.