title: Morphological adaptation of the tarso-metatarsal joints onto load transmission in the foot.
abstract: OBJECTIVE
  Undefined middle foot pain among older individuals is an increasingly problem. Thereby the tarso-metatarsal joints (Lisfranc's joint, TMT joints) are particularly important for foot structure. The aim of this study was to obtain into force transmission in TMT joints by analysing degenerative morphological changes (DMC) of the articular cartilage and subchondral density patterns.
  
  
  METHODS
  We used seven formalin-fixed foot preparations (average age 80.8) from the undergraduate dissection course. Applying the Collins schema, localisation of cartilaginous surface DMC was examined. For showing subchondral density patterns, the well-established method of CT-osteoabsorptiometry (CT-OAM) was used.
  
  
  RESULTS
  The cartilaginous surface DMCs were frequently located at the medial edges. Maximum density areas were found at the medial and dorsal edges. There was a clear correlation of topical cartilage degeneration and subchondral density.
  
  
  CONCLUSIONS
  In healthy feet, force transmission in the TMT joints appears to occur via the dorsal and medial edges. Considering the correlation of topical cartilaginous surface DMC and subchondral density patterns, clinical application of CT-OAM seems to be recommendable in the case of undefined middle foot pain.
authors.affiliation: Anatomische Anstalt der Ludwig-Maximilians Universität, Pettenkoferstr. 11, Munich 80336, Germany. christine.ebel@med.uni-muenchen.de
authors.forename: Christine Maria Isabel
authors.initials: CM
authors.lastname: Ebel
authors.forename: Peter M
authors.initials: PM
authors.lastname: Prodinger
authors.forename: Heinz
authors.initials: H
authors.lastname: Mühlhofer
authors.forename: Magdalena
authors.initials: M
authors.lastname: Müller-Gerbl
authors.forename: Ulrich
authors.initials: U
authors.lastname: Linsenmaier
authors.forename: Reinhard
authors.initials: R
authors.lastname: Putz
mesh_terms: D000222:Adaptation, Physiological; D000368:Aged; D000369:Aged, 80 and over; D002358:Cartilage, Articular / Q000473:pathology; D005534:Foot Diseases / Q000473:pathology; D033023:Foot Joints / Q000473:pathology / Q000502:physiology*; D006801:Humans; D016474:Weight-Bearing