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Todd Borenstein MD

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Hindfoot Arthritis

Hindfoot arthritis results from loss of cartilage in the rear joints of the foot, which leads to pain and swelling. These symptoms are often aggravated by increased activity and can lead to a painful limp.

What causes arthritis?

Arthritis of the hindfoot is often due to trauma such as a calcaneus (heel bone) fracture, talus fracture, and navicular fractures but may also be due to irregular loading of the joints from deformity or congenital defects.

What are the symptoms of hindfoot arthritis?

Patients with hindfoot arthritis often complain of ankle pain, a painful limp, stiffness in the rear foot joint and swelling. When the arthritis is severe, patients may feel grinding in the joint.

How is hindfoot arthritis diagnosed?

Loss of cartilage in the hindfoot joint is most often diagnosed with medical history, physical examination and with X-rays. X-rays will show loss of joint space, bone spurs and sclerosis (whitening of the bone at the joint). Computed tomography (CT) scans and magnetic resonance imaging (MRI) scans can also be used to diagnose hindfoot arthritis.

How is forefoot arthritis diagnosed?

Forefoot arthritis is diagnosed with medical history, thorough physical examination and imaging studies. X-rays will be ordered to evaluate for any bony abnormalities such as joint space narrowing and bone spurs. An MRI may also be ordered.

How is hindfoot arthritis treated?

Nonsurgical treatment

Nonsurgical treatment for hindfoot arthritis is meant to improve function and decrease pain. These treatments consist of activity modifications and weight loss (to limit loading through the joint), medications and injections (to decrease symptoms of swelling and pain) and physical therapy, bracing, orthotics and comfort shoes (to improve joint kinematics).

Operative treatment

Operative treatments are used when nonsurgical treatments are unsuccessful. When the arthritis is more severe, joint fusion may be performed. This may include arthrodesis of the subtalar joint, talonavicular joint and calcaneocuboid joints. Often a subtalar joint arthrodesis if the best procedure after a heel fracture or for deformity. These surgeries are excellent for providing pain relief.