Midfoot arthritis is a condition where the joints in the middle of the foot become inflamed due to degeneration of the cartilage that covers the ends of bones. This degeneration causes bones to rub together, leading to pain, swelling, and stiffness. Over time, the condition can limit movement and make it painful to move. Midfoot fusion is a surgical treatment for midfoot arthritis.  Fusion of the midfoot involves joining together some or all of the affected joints in the middle of the foot, depending on the severity of the condition. By fusing these joints, the movement that causes pain is eliminated, which can help to alleviate the pain caused by arthritis.

Symptoms

Midfoot arthritis is characterized by pain at the midfoot. Standing, walking and twisting the foot cause increased pain and at times popping that occurs at the arch of the foot. It is best to consult with a specialist when diagnosing conditions that may require midfoot fusion surgery. Board-certified specialists have the necessary training to identify conditions such as osteoarthritis, rheumatoid arthritis, Charcot arthropathy, and other related conditions. In addition to these conditions, severe midfoot fractures, acute trauma, and other injuries can also lead to midfoot fusion surgery. If you are experiencing pain in your midfoot, it is important to seek the help of a specialist such as those at Flint Foot and Ankle. They can help you find a solution to alleviate your pain regardless of its cause.

Midfoot Fusion Procedure

During midfoot fusion surgery, one or multiple incisions are made at the top of the foot, with the length and number of incisions depending on the number of joints that need to be fused. Careful separation of muscles is performed to protect nerves and tendons, which exposes the joints in the midfoot. The surgeon removes any remaining arthritic and damaged cartilage from the affected joints and prepares them for fusion. Metal implants such as plates and screws or nitinol staples are used to immobilize and compress the joint, allowing bone to form across the joint space. In many cases, bone graft may be used to fill any gaps that occur during cartilage removal. Bone graft is typically used from donated bone from a cadaver or bone from the patient may be used, most often, from the iliac crest (bony prominence at belt line). Any additional repairs are performed by the surgeon, who then closes the incisions with sutures and sterile bandages.

Post Operative Care

After midfoot fusion surgery, the postoperative care instructions generally consist of several basic steps. The patient is first transferred to a recovery area where they are closely monitored as they recover from the initial procedure. Patients may stay in the hospital overnight. They are then released to go home and given pain medication to help alleviate the pain, swelling, and discomfort that can result from this type of surgery.

To allow the midfoot bones to fuse adequately, the patient is not able to bear weight on the operated leg for quite often 3 months. Crutches, walker, or a knee trolley may also be used while the patient is in the process of healing. Ice can be applied to reduce pain and swelling after surgery.

Physical Therapy

Once the patient is able to bear weight, they may require physical therapy. Physical therapy or rehabilitation can help to improve the strength of the foot faster and may also improve walking ability faster. It is important to note that full recovery from midfoot fusion surgery can take up to a year. It is best to gradually increase activity levels to prevent injury and pain. It is recommended to only return to sports when the foot has regained normal strength, and the doctor has approved this type of activity.

Complications

Every surgery carries some level of risk, and midfoot fusion surgery is no exception. However, it is generally considered a safe and effective option for treating midfoot arthritis. Patients may experience unique risks associated with this procedure, such as nonunion or the failure of the bones to fuse together. Pain at the hardware sites, over or under correction (malunion), and nerve injury are also potential complications of this surgery. Skin healing issues may also be a concern given the thin skin that is over the top of the foot. In addition, there are general surgical risks to consider, including infection, damage to nerves and blood vessels, and bleeding or blood clots.

If you are experiencing midfoot pain, the highly trained and experienced team at Flint Foot and Ankle is available to provide assistance. Your feet deserve the best care by a fellowship-trained foot and ankle orthopedic surgeon. Midfoot fusion is one of the many treatment options available through our specialized team to help you regain optimal foot health and function. We are committed to providing our patients with comprehensive care, from diagnosis to treatment and rehabilitation, to ensure the best possible outcome. Don’t hesitate to contact us for a consultation if you are experiencing midfoot pain or discomfort.