Midfoot Arthritis and PRP — A New Approach


Midfoot arthritis is one of the more challenging problems that we treat at our clinic. It often affects the second or possibly third metatarsal-cuneiform joint. There is localized swelling and pain in the midfoot. Especially with activities like walking or running, and as soon as the heel comes up off the ground there is a compression load to the top of the midfoot. Ultrasound imaging usually shows extensive bone spurs in this area and inflammation. X-rays can also show the bone spurs but often this is more difficult to visualize with an x-ray.

Treatment in the past has included a midfoot fusion and sometimes a simple bone spur cleanup procedure and release of the tight calf muscle as another alternative. We often treat this with injections of Supartz which is a very effective synthetic joint lubricant. This is helpful as an initial treatment. A new treatment that we are now offering is a series of 2-3 PRP injections (platelet rich plasma) approximately 3–4 weeks apart. This is followed by shockwave therapy or EPAT. PRP injections into an arthritic joint have been helpful at improving the underlying arthritic condition.  They can help with regeneration of some of the cartilage elements. Although the joint is never perfect, the improvement can be quite significant. We use ultrasound guidance when we do these platelet rich plasma injections. The procedure itself actually has very normal pain because of our local anesthetic technique.

If you are experiencing midfoot arthritis or any foot/ankle pain, give us a call at 425-391-8666 or make an appointment online. Myself, Dr. Timothy Young or my partner Dr. Brandon Nelson would be happy to see you.

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