Patient case: Concurrent midfoot arthritis (1-3 TMT joints) and varus ankle arthritis

1688316093785.jpg?1749318689863William Crawford, MD FAAOS

Orthopaedic Surgeon: Fellowship Trained in Foot and Ankle/Lower Extremity Trauma

To stage ? ? To stem ? ?

With many joints in the foot and ankle, patients can present with various symptoms and various treatments may be needed.

Patients are often interested in a single procedure and single recovery. Depending on the concurrent pathology, this may require significant increased time under anesthesia and increased risk. When possible, I try to accommodate. When procedures take enough time added together, the risk isn’t worth the reward, and I stage the surgeries, stacking the recovery.

This is the case of a 78 year old patient with concurrent midfoot arthritis (1-3 TMT joints) and varus ankle arthritis. I chose to tackle the midfoot fusion (hashtag#Arthrodesis) first, using OSSIO hashtag#Staples and hashtag#ThreadedTrimmableFixationNails (Although good luck finding them on XR ). Their second stage addressed the ankle arthritis with hashtag#AnkleReplacement.

Now over 6 months out from the ankle replacement, and 8 months from midfoot fusion, they are going on 3 mile walks, and steadily continuing to improve !!

To the surgeons out there, how often do you stage procedures ? ?

Who would use a stemmed implant ? ?

Texas Orthopaedic Associates - A Division of OrthoLoneStar

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Managing concurrent midfoot and varus ankle arthritis presents unique surgical challenges—especially when it comes to staging procedures for stability and long-term outcomes. This real-world case highlights the importance of thoughtful planning, fixation strategies, and a tailored approach to complex deformity correction.

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