Prevention and treatment of metatarsal arthritis

The metatarsal joint is a very fragile joint. Because of its special position, it is subject to strong pressure, which can easily lead to inflammation of the metatarsal joint and induce metatarsal arthritis. Once the joint is inflamed, it is difficult to treat and the pain for the patient is enormous. It can only be completely cured through surgery. Therefore, prevention is very important. So, what are the prevention and treatment of metatarsal arthritis? No.1

Osteoarthritis of the joint is extremely common and is often caused by a change in the position of the first metatarsal due to excessive ankle pronation (pronation), outward deviation of the metatarsal (horsetail valgus), dorsiflexion of the first metatarsal (metatarsal high), or increased length or inward deviation of the first metatarsal. Occasionally, trauma is also a cause.

Prevention and treatment of metatarsal head osteoarthritis: Wearing protective shoes with metatarsal pads to maintain the normal load-bearing point of the foot and regular exercise of the foot muscles can reduce the incidence of this disease, reduce the pressure on the metatarsal bones, and relieve pain. Most patients can be treated non-surgically. Avoid weight bearing in the early stage, use walking plaster to fix the foot, maintain a good transverse arch, and wear shoes with metatarsal pads to reduce the pressure on the metatarsal bones. If the pain worsens in the late stage, a hole can be drilled on the dorsal side of the metatarsal neck to reduce pressure or a window can be opened to scrape out the dead bone, and cancellous bone can be grafted to promote vascular regeneration and induce bone regeneration. If the second toe grows excessively, the second metatarsal head can be removed and a metatarsophalangeal joint arthroplasty can be performed.

Pathology of metatarsal head osteoarthritis: 1. Cartilage necrosis stage: Cartilage cells condense, the structure disappears, dissolves and liquefies. 2. Cartilage repair stage ① Angiogenesis stage, necrotic tissue is absorbed, and granulation tissue rich in blood vessels and fiber components grows near the healthy bone of the necrotic bone, extending into the bone necrotic area and being replaced by the granulation tissue. ② During the bone regeneration period, part of the necrotic bone is absorbed, and a large amount of unabsorbed bone tissue serves as the skeleton for new bone regeneration. New bone is deposited on it, making the trabeculae thicker and more numerous. The cartilage components also rebuild the bone structure through angiogenesis and ossification. ③ During the repair period of bone necrosis, metatarsal head deformation may occur due to weight-bearing or repeated minor trauma, gradually forming osteoarthritis.

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