title: Midfoot and forefoot osteoarthritis.
abstract: BACKGROUND
  Foot osteoarthritis (OA) is linked with chronic foot pain and functional impairment.
  
  
  OBJECTIVE
  To review the current knowledge on midfoot and forefoot OA.
  
  
  METHODS
  PubMed, CINAHL, PEDro, and the ISI Web of Science databases (1950-2013) were searched for keywords: foot OA, midfoot OA, forefoot OA and metatarsal OA. The search was limited to reports in human subjects and English language. Published cohort, cross-sectional studies and clinical trials relating to epidemiology, clinical features, functional impairment, risk factors and treatment were included.
  
  
  RESULTS
  We found heterogeneity in the design, radiographic views and grading systems used among studies. Most of the literature focused on radiographic OA, being the prevalence between 0.1% and 61%, depending on gender, age and joint evaluated. The age and female gender were the main associated factors, whereas structural (bone length) and mechanical factors (hypermobility, altered tarso-metatarsal stress, etc.) seemed to be related. Various treatments are widely used, i.e. physical therapy, orthotics, steroid injection, analgesics and arthrodesis. However, scarce research supports their efficacy.
  
  
  CONCLUSIONS
  Most of the current knowledge comes from observational and small case-control studies. Future population-based studies as well as controlled studies are essential to understand the risk factors and to evaluate the effectiveness of treatment options.
authors.affiliation: Department of Physical Therapy, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel.
authors.forename: Leonid
authors.initials: L
authors.lastname: Kalichman
authors.affiliation: Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Col. Sección XVI, 1400 Mexico City, Mexico. Electronic address: gabyhm@yahoo.com.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Hernández-Molina
mesh_terms: D019468:Disease Management; D033023:Foot Joints; D014943:Global Health; D006801:Humans; D015994:Incidence; D019637:Orthopedic Procedures / Q000379:methods*; D010003:Osteoarthritis / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D012720:Severity of Illness Index
keywords: Foot; Foot osteoarthritis; Forefoot; Midfoot