Progressive Collapsing Foot Deformity Classes Correction after Isolated Arthroscopic Anterolateral Subtalar Arthrodesis
Category: Hindfoot; Midfoot/Forefoot Introduction/ Purpose: Subtalar osteoarthritis in the context of flatfoot recently renamed Progressive Collapsing Foot Deformity (PCFD) may be treated through subtalar joint (SJ) arthrodesis with anticipated consequences on three-dimensional bony configuration. T...
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2024-12-01
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| Series: | Foot & Ankle Orthopaedics |
| Online Access: | https://doi.org/10.1177/2473011424S00449 |
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| author | Alessio Bernasconi MD, PhD Matthieu Lalevée MD Céline Fernando PhD Antonio Izzo MD Cesar de Cesar Netto MD, PhD François Lintz MD, PhD |
| author_facet | Alessio Bernasconi MD, PhD Matthieu Lalevée MD Céline Fernando PhD Antonio Izzo MD Cesar de Cesar Netto MD, PhD François Lintz MD, PhD |
| author_sort | Alessio Bernasconi MD, PhD |
| collection | DOAJ |
| description | Category: Hindfoot; Midfoot/Forefoot Introduction/ Purpose: Subtalar osteoarthritis in the context of flatfoot recently renamed Progressive Collapsing Foot Deformity (PCFD) may be treated through subtalar joint (SJ) arthrodesis with anticipated consequences on three-dimensional bony configuration. This study investigates the correction of PCFD-related deformities achieved after Anterolateral Arthroscopic Subtalar Arthrodesis (ALAPSTA). Methods: In this retrospective study, we evaluated pre- and post-operative (at 6 months) weight bearing computed tomography (WBCT) images of patients diagnosed with PCFD with a degenerated SJ (2A according to PCFD classification) and/or peritalar subluxation (2D) with or without associated flexible midfoot and/or forefoot deformities (1B, 1C and 1E) which underwent ALAPSTA as a standalone procedure between 2017 and 2020. Multiple measurements were used to assess and compare pre and post-operative PCFD classes. Results: Thirtythree PCFD (33 patients, median age 62) were included. Preoperative medial facet subluxation was 28.3%. Overall PCFD 3D deformity improved with a reduction of the foot and ankle offeset from 9.3 points to 4 (p< 0.001). Class A (hindfoot valgus, measured through the tibiocalcaneal angle, the calcaneal moment arm, the calcaneal offset and the hindfoot angle), class B (midfoot abduction, measured using the talonavicular coverage angle and the axial talo-first metatarsal angle) and class C (forefoot varus, measured through the sagittal talo-first metatarsal angle and the forefoot arch angle) significantly improved after surgery (p< 0.001 for all measurements). No patient had a valgus deformity at the ankle pre-operatively (therefore no patient presented with class E), and no significant change of the talar tilt was observed (p=0.12). Conclusion: In this series, ALAPSTA performed as a standalone procedure to treat patients diagnosed with PCFD with a degenerated subtalar joint and/or peritalar subluxation was effective not only at correcting hindfoot alignment but also flexible midfoot abduction and flexible forefoot varus. |
| format | Article |
| id | doaj-art-91f0056bb5bc486e86598f34b796aa45 |
| institution | DOAJ |
| issn | 2473-0114 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Foot & Ankle Orthopaedics |
| spelling | doaj-art-91f0056bb5bc486e86598f34b796aa452025-08-20T02:56:01ZengSAGE PublishingFoot & Ankle Orthopaedics2473-01142024-12-01910.1177/2473011424S00449Progressive Collapsing Foot Deformity Classes Correction after Isolated Arthroscopic Anterolateral Subtalar ArthrodesisAlessio Bernasconi MD, PhDMatthieu Lalevée MDCéline Fernando PhDAntonio Izzo MDCesar de Cesar Netto MD, PhDFrançois Lintz MD, PhDCategory: Hindfoot; Midfoot/Forefoot Introduction/ Purpose: Subtalar osteoarthritis in the context of flatfoot recently renamed Progressive Collapsing Foot Deformity (PCFD) may be treated through subtalar joint (SJ) arthrodesis with anticipated consequences on three-dimensional bony configuration. This study investigates the correction of PCFD-related deformities achieved after Anterolateral Arthroscopic Subtalar Arthrodesis (ALAPSTA). Methods: In this retrospective study, we evaluated pre- and post-operative (at 6 months) weight bearing computed tomography (WBCT) images of patients diagnosed with PCFD with a degenerated SJ (2A according to PCFD classification) and/or peritalar subluxation (2D) with or without associated flexible midfoot and/or forefoot deformities (1B, 1C and 1E) which underwent ALAPSTA as a standalone procedure between 2017 and 2020. Multiple measurements were used to assess and compare pre and post-operative PCFD classes. Results: Thirtythree PCFD (33 patients, median age 62) were included. Preoperative medial facet subluxation was 28.3%. Overall PCFD 3D deformity improved with a reduction of the foot and ankle offeset from 9.3 points to 4 (p< 0.001). Class A (hindfoot valgus, measured through the tibiocalcaneal angle, the calcaneal moment arm, the calcaneal offset and the hindfoot angle), class B (midfoot abduction, measured using the talonavicular coverage angle and the axial talo-first metatarsal angle) and class C (forefoot varus, measured through the sagittal talo-first metatarsal angle and the forefoot arch angle) significantly improved after surgery (p< 0.001 for all measurements). No patient had a valgus deformity at the ankle pre-operatively (therefore no patient presented with class E), and no significant change of the talar tilt was observed (p=0.12). Conclusion: In this series, ALAPSTA performed as a standalone procedure to treat patients diagnosed with PCFD with a degenerated subtalar joint and/or peritalar subluxation was effective not only at correcting hindfoot alignment but also flexible midfoot abduction and flexible forefoot varus.https://doi.org/10.1177/2473011424S00449 |
| spellingShingle | Alessio Bernasconi MD, PhD Matthieu Lalevée MD Céline Fernando PhD Antonio Izzo MD Cesar de Cesar Netto MD, PhD François Lintz MD, PhD Progressive Collapsing Foot Deformity Classes Correction after Isolated Arthroscopic Anterolateral Subtalar Arthrodesis Foot & Ankle Orthopaedics |
| title | Progressive Collapsing Foot Deformity Classes Correction after Isolated Arthroscopic Anterolateral Subtalar Arthrodesis |
| title_full | Progressive Collapsing Foot Deformity Classes Correction after Isolated Arthroscopic Anterolateral Subtalar Arthrodesis |
| title_fullStr | Progressive Collapsing Foot Deformity Classes Correction after Isolated Arthroscopic Anterolateral Subtalar Arthrodesis |
| title_full_unstemmed | Progressive Collapsing Foot Deformity Classes Correction after Isolated Arthroscopic Anterolateral Subtalar Arthrodesis |
| title_short | Progressive Collapsing Foot Deformity Classes Correction after Isolated Arthroscopic Anterolateral Subtalar Arthrodesis |
| title_sort | progressive collapsing foot deformity classes correction after isolated arthroscopic anterolateral subtalar arthrodesis |
| url | https://doi.org/10.1177/2473011424S00449 |
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