Medial tarsometatarsal injuries lead to overall post-traumatic osteoarthritis in 1 in 3 patients: A systematic review and meta-analysis

Introduction Medial tarsometatarsal (TMT) injuries have often occurred. One of complications is post-traumatic osteoarthritis (PTOA). The Actual incidence of PTOA is still unknown and risk factors is no definite consensus. This systematic review and meta-analysis aim to examine the actual incidence of PTOA and determine the actual factors related following medial Lisfranc injuries. Method The systematic review were performed according to PRISMA guidelines. The search terms were searcheed in PubMed and Google Scholar. From an initial search,1532 studies were found ,14 eligible studies were selected for further review. The meta-analysis results were extracted and reported by the Forest plots model. Levels of heterogeneity were also evaluated from the eligible studies. Result A total of 686 patients was included. The primary outcome is actual incidences of PTOA following medial TMT injuries was 33% . The secondary outcomes were the actual factors affecting higher severity of PTOA. This result revealed non-anatomical reduction could be a risk factor of PTA significantly. The percentage of Myerson classification ≥ C was identified as a source of prevalence of PTOA in the meta-regression method. Conclusion PTOA following the medial TMT injuries occurred about 33% with mean follow-up time about 60 months. Non-anatomical reduction was a single factor that increased overall PTOA rate. Higher severity of injury (Myerson classification type C or higher severity type) and non-anatomical reduction increased the rate of severe PTOA. Anatomical reduction is recommended in the patients with medial TMT injury.