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Updated: May 16, 2026

Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
Published on: January 24, 2018
Ceramic interpositional arthroplasty for fourth and fifth tarsometatarsal joint arthritis
Nicholas A Viens1, Samuel B Adams, James A Nunley
1Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA.
Abstract:
The lateral midfoot is significantly more mobile than the corresponding medial joints, thereby giving some surgeons concern over the use of arthrodesis in patients with symptomatic fourth and fifth tarsometatarsal arthritis. Limited treatment options exist for these patients when nonoperative measures fail to provide adequate pain relief. A retrospective, consecutive case series was performed to evaluate the short-term results for patients who underwent ceramic interpositional arthroplasty of the lateral tarsometatarsal joints. All five patients had subjectively improved lateral midfoot pain and retained some motion following the procedure. There were no implant failures or cases of subsidence identified. Two patients experienced wound healing complications and four patients required concomitant procedures at the time of interpositional arthroplasty, highlighting the complexity that is often involved when treating patients with midfoot arthritis. Long-term results are needed to determine the ultimate role for ceramic interpositional arthroplasty in the lateral midfoot.
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