This paper presents the first report of a prospective study to assess the outcome of using coregistration localisation and selective arthrodesis in chronic midfoot degenerative arthritis.

In a previous report from Cambridge (J Bone Jt Surg [Br]1998; 80B:777), a new coregistration imaging technique in the foot was described, using superimposed X-rays and technetium scintigram and showing significantly higher anatomical localisation of active joint disease than either alone.

Nineteen consecutive patients over a three-year period (1996–9) with severe midfoot joint pain and disability of over six months’ duration underwent coregistration imaging followed by selective arthrodesis. The procedures involved 17 patients with one-level single or multiple fusions of the metatarsocuneiform, metatarsocuboid or naviculocuneiform joints, and two patients with two-level multiple fusions.

Pain and functional assessments were recorded pre-operatively and at one and at two to four years postoperatively using the American Orthopaedic Foot and Ankle Society Midfoot Scoring System. Bone union was determined clinically and with X-rays.

Results showed fusions in all 19 patients between 10 and 15 weeks. Three K-wires and one screw required removal for later prominence and there was one delayed wound healing. Pian and functional scores showed significant differences between the pre- and post-operative and one year measurements, and less between the one year and two to four year scores.

This preliminary study concludes that there is a high correlation between the coregistration localisation of the midfoot degenerative arthropathies and the successful results of selective fusion of these joints for the one to four year follow-up period.