Assessing the Biomechanical, Kinematic, and Force Distribution Properties of the Foot Following Tarsometatarsal Joint Arthrodesis: A Systematic Review

Author:

Balu Abhinav Reddy1,Baumann Anthony N.2ORCID,Burkhead Daniel3,Talaski Grayson M.4ORCID,Anastasio Albert T.5ORCID,Walley Kempland C.6,Adams Samuel B.5

Affiliation:

1. Feinberg School of Medicine, Northwestern University, Chicago, IL 60208, USA

2. College of Medicine, Northeast Ohio Medical University, Rootstown, OH 44272, USA

3. Campbell University School of Osteopathic Medicine, Lillington, NC 27546, USA

4. Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA 52242, USA

5. Department of Orthopaedic Surgery, Duke University, Durham, NC 27708, USA

6. Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI 48109, USA

Abstract

The Lisfranc joint connects the forefoot to the midfoot. Tarsometatarsal (TMT) arthrodesis is commonly employed for Lisfranc joint injuries; however, there is active discussion regarding the optimal method of fixation for TMT arthrodesis. The purpose of this systematic review is twofold: to assess the stability of various constructs used in TMT arthrodesis and to evaluate joint motion and force distribution in the foot following arthrodesis. The PubMed, CINAHL, MEDLINE, and Web of Science databases were searched for articles evaluating biomechanical and kinetic properties of TMT arthrodesis constructs in accordance with PRISMA guidelines. The preliminary search yielded 367 articles and the final review included 14 articles with 195 cadaveric and 70 synthetic bone constructs. Plantar plates and intramedullary screw fixation at the first TMT joint were consistently found to bear significantly greater loads and resist diastasis more effectively than crossed screws. Furthermore, whole foot and lateral column arthrodesis significantly elevate calcaneocuboid and lateral column pressures. This increase was not observed with isolated fourth or fifth TMT arthrodesis. TMT arthrodesis should aim to avoid the lateral column and fuse as few joints as possible. Overall, plantar plates are an effective construct for first TMT arthrodesis due to their ability to withstand both compressive and tensile forces while maintaining stable alignment of the foot via reinforcement of the transverse arch. Intramedullary fixation devices are an alternative option that provide a high degree of active compression across the joint space while avoiding irritation of surrounding soft tissue structures.

Publisher

MDPI AG

Subject

Fluid Flow and Transfer Processes,Computer Science Applications,Process Chemistry and Technology,General Engineering,Instrumentation,General Materials Science

Reference36 articles.

1. Tarsometatarsal Arthrodesis for Lisfranc Injuries;Bevilacqua;Clin. Podiatr. Med. Surg.,2017

2. Management of Tarsometatarsal Joint Injuries;Weatherford;J. Am. Acad. Orthop. Surg.,2017

3. Comparison of primary arthrodesis versus open reduction with internal fixation for Lisfranc injuries: Systematic review and meta-analysis;Han;J. Postgrad. Med.,2019

4. Current management of tarsometatarsal injuries in the athlete;Myerson;J. Bone Jt. Surg. Am.,2008

5. In vitro determination of midfoot motion;Ouzounian;Foot Ankle,1989

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