Trephine-based in situ arthrodesis of the central tarsometatarsal joints: Clinical outcomes.

BACKGROUND

Osteoarthritis of the second and third tarsometatarsal (TMT) joints is a common cause of midfoot pain. Arthrodesis is a reliable treatment, although optimal joint preparation and fixation remain debated.

METHODS

A retrospective cohort study included 31 feet in 30 patients undergoing isolated or combined second and third TMT arthrodesis for idiopathic osteoarthritis (2016-2022). The technique used trephine-based joint preparation, calcaneal autograft, and nitinol staple fixation. Outcomes included MOXFQ, AOFAS scores, union, and complications.

RESULTS

Radiographic union was achieved in 95.5% of joints. MOXFQ improved from 33.3 to 9.9 and AOFAS from 37.6 to 77.3 (p < .001). No transfer metatarsalgia was observed. Implant removal occurred in 6.5% and staple breakage in 9.7%.

CONCLUSION

This technique provides high union rates, significant functional improvement, and a low complication profile in selected patients.

LEVEL OF EVIDENCE: Level IV, retrospective case series.