TY - JOUR
T1 - Arthroscopic Findings in Refractory Symptomatic Fourth and Fifth Tarsometatarsal Joints
AU - Liu, George T.
AU - Vanpelt, Michael D.
AU - Manchanda, Kshitij
AU - Johnson, Matthew J.
AU - Raspovic, Katherine M.
AU - Wukich, Dane K.
AU - Lalli, Trapper
N1 - Publisher Copyright:
© 2022
PY - 2022/11/1
Y1 - 2022/11/1
N2 - Refractory pain to the fourth and fifth tarsometatarsal (TMT) joint can be a source of disability and functional impairment. While pain has been attributed to injury, post-traumatic arthritis, arthrofibrosis, the principal causes of pain in the absence of arthritis are not well elucidated. The purpose of this study is to characterize arthroscopic pathology associated with chronic refractory pain to the fourth and fifth TMT joints. We retrospectively examined 24 patients that underwent arthroscopic surgery of the fourth and fifth TMT joints for refractory pain at our academic institution between 2015 and 2019. We used the Outerbridge classification for chondral lesions, the Kellgren Lawrence radiographic classification for osteoarthritis, and described intraarticular pathologies as acute hypertrophic synovitis, chronic synovial fibrosis, hyaline bands, meniscoid bodies, loose joint bodies, arthrofibrosis. Approximately, 31 of 45 TMT joints (68.9%) presented with radiographic evidence of arthritis. Approximately, 14 of 45 TMT joints (31.11%) were absent of radiographic signs of arthritis. The frequency of soft tissue pathology seen in these patients without radiographic evidence of arthritis was arthrofibrosis (87.5%), chronic synovial fibrosis (75.0%), and acute hypertrophic synovitis (62.5%). This is the first study to report arthroscopic pathologies associated with refractory pain to the fourth and fifth TMT joints.
AB - Refractory pain to the fourth and fifth tarsometatarsal (TMT) joint can be a source of disability and functional impairment. While pain has been attributed to injury, post-traumatic arthritis, arthrofibrosis, the principal causes of pain in the absence of arthritis are not well elucidated. The purpose of this study is to characterize arthroscopic pathology associated with chronic refractory pain to the fourth and fifth TMT joints. We retrospectively examined 24 patients that underwent arthroscopic surgery of the fourth and fifth TMT joints for refractory pain at our academic institution between 2015 and 2019. We used the Outerbridge classification for chondral lesions, the Kellgren Lawrence radiographic classification for osteoarthritis, and described intraarticular pathologies as acute hypertrophic synovitis, chronic synovial fibrosis, hyaline bands, meniscoid bodies, loose joint bodies, arthrofibrosis. Approximately, 31 of 45 TMT joints (68.9%) presented with radiographic evidence of arthritis. Approximately, 14 of 45 TMT joints (31.11%) were absent of radiographic signs of arthritis. The frequency of soft tissue pathology seen in these patients without radiographic evidence of arthritis was arthrofibrosis (87.5%), chronic synovial fibrosis (75.0%), and acute hypertrophic synovitis (62.5%). This is the first study to report arthroscopic pathologies associated with refractory pain to the fourth and fifth TMT joints.
KW - 4
KW - fifth tarsometatarsal
KW - fourth tarsometatarsal
KW - lateral column foot pain
KW - lateral tarsometatarsal
KW - small joint arthroscopy
UR - http://www.scopus.com/inward/record.url?scp=85126514585&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85126514585&partnerID=8YFLogxK
U2 - 10.1053/j.jfas.2022.02.009
DO - 10.1053/j.jfas.2022.02.009
M3 - Article
C2 - 35307157
AN - SCOPUS:85126514585
SN - 1067-2516
VL - 61
SP - 1235
EP - 1239
JO - Journal of Foot and Ankle Surgery
JF - Journal of Foot and Ankle Surgery
IS - 6
ER -