Foot root osteoarthritis is classified according to location and severity:

1. Local osteoarthritis:
   • Affects individual joints in the foot root, such as the Lisfranc joint or the Chopart joint.
2. Generalized osteoarthritis:
   • Includes multiple joints in the foot root and can also affect adjacent areas such as the midfoot.
3. Post-traumatic osteoarthritis:
   • Develops as a result of injuries, such as bone fractures or ligament injuries, leading to misalignment or overloading of the joints.

The causes of tarsal arthritis are diverse and include:

• Aging processes:
  • With increasing age, cartilage loses elasticity and resilience, leading to increased wear.
• Mechanical overload:
  • Excessive loads, such as prolonged standing, intensive walking, or sports with high impact loads, promote cartilage degradation.
• Injuries:
  • Traumas such as bone fractures or sprains can permanently damage the joint structure and promote arthritis.
• Misalignments:
  • Foot misalignments such as flatfoot or high arch increase the load on certain areas of the tarsus and promote wear.
• Inflammatory diseases:
  • Chronic diseases such as rheumatoid arthritis can damage cartilage and joint structures.

The symptoms of tarsal arthritis are varied and usually develop gradually:

• Pain:
  • Initially, pain occurs only during exertion, later also at rest. Dull pain in the tarsal area is typical.
• Stiffness:
  • Especially after periods of rest or in the morning, it is difficult to move the foot.
• Swelling:
  • Inflammatory reactions in the affected area can lead to swelling.
• Movement restrictions:
  • The range of motion of the foot becomes increasingly restricted, making walking and standing difficult.
• Deformities:
  • In advanced stages, visible changes in the shape of the foot may occur.
• Grinding or rubbing:
  • When moving the affected joints, crepitus sounds are often audible.

The diagnosis is made through a combination of medical history, clinical examination, and imaging techniques:

- Medical history:

- The doctor inquires about the symptoms, their duration, and possible triggers such as injuries or misalignments.

- Physical examination:

- Checking mobility, tenderness, and visual inspection for swelling or deformities.

- Imaging techniques:

- X-ray: Visualization of joint space narrowing, osteophytes, and bony changes.

- MRI: Detailed assessment of cartilage and soft tissue damage.

- CT: Precise depiction of complex changes in the tarsal bones.

Conservative Therapy Most cases of tarsal arthritis can be treated without surgery:

• Pain therapy:
  • Use of anti-inflammatory medications like ibuprofen to relieve acute discomfort.
• Physiotherapy:
  • Exercises to improve mobility and strengthen the foot muscles.
  • Manual therapy to relieve the affected joints.
• Orthopedic aids:
  • Special shoe inserts or heel cushions to support and relieve the foot.
• Shock wave therapy:
  • Promotion of blood circulation and pain relief through high-energy sound waves.

Surgical Therapy In severe cases or with progressive discomfort, surgery may be necessary:

• Joint fusion (arthrodesis):
  • Fixation of the affected joint to eliminate pain and restore stability.
• Cartilage transplantation:
  • In rare cases, cartilage transplants can be performed to restore joint function.
• Prostheses:
  • Use of artificial joints in severely damaged joint surfaces.

The following measures are helpful in preventing tarsal arthritis:

1. Ergonomic footwear: Wearing shoes with good cushioning and support.
2. Regular exercise: Promoting foot health through targeted exercises.
3. Weight management: Reducing excess weight to minimize stress on the tarsal bones.
4. Early treatment: Immediate clarification and therapy at the first signs of pain or misalignment.
5. Protection against injuries: Avoiding sports with a high risk of injury or using protective gear.