Tarsometatarsal Arthritis Associated with Progressive Collapsing Flatfoot Deformity Can be Improved Without Arthrodesis by Restoration of Medial Longitudinal Arch

Research Type: Level 4 – Case series Introduction/Purpose: Progressive collapsing flatfoot deformity (PCFD) has been reported as a common cause of the non-traumatic degenerative arthritis of the midfoot, and arthrodesis has been used for symptomatic arthritis unresponsive to non-operative measures. The hypothesis of this study was that non-traumatic tarsometatarsal (TMT) arthritis associated with PCFD would be improved without arthrodesis by restoration of medial longitudinal arch. The aim of this study was to investigate the clinical and radiological results of TMT arthritis with medial longitudinal arch restoration in PCFD. Methods: From April 2017 to December 2022, 18 patients(21 feet) with non-traumatic TMT arthritis and PCFD who underwent medial longitudinal arch reconstruction were included. Mean follow-up was 30.2(range, 12-67) months. Clinical findings were evaluated with VAS and FFI. Radiological staging of second TMT joint was assessed because it was the most common and severely involved joint. Changes in radiographic parameters for PCFD were assessed. Results: Clinical results were improved. VAS changed from 7.1±1.3 to 1.6±0.5, FFI changed from 53.3±0.5 to 12.2±7.0 at preoperative and postoperative period respectively. Radiological stage of the second TMT joint was improved from 3.4(range 2 to 4) to 1.2(range 1 to 2). Lateral talo-first metatarsal angle was improved from 33.3.±7.4 to 16.8±5.4 degrees. Conclusion: Non-traumatic tarsometatarsal arthritis associated with progressive collapsing flatfoot deformity was improved clinically and radiologically without arthrodesis by medial longitudinal arch reconstruction.