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Effect of Peritalar Subluxation Correction for Progressive Collapsing Foot Deformity on Patient-Reported Outcomes.

Publication ,  Journal Article
de Cesar Netto, C; Barbachan Mansur, NS; Lalevee, M; Carvalho, KAMD; Godoy-Santos, AL; Kim, KC; Lintz, F; Dibbern, K
Published in: Foot Ankle Int
November 2023

BACKGROUND: Peritalar subluxation (PTS) is part of progressive collapsing foot deformity (PCFD). This study aimed to evaluate initial deformity correction and PTS optimization in PCFD patients with flexible hindfoot deformity undergoing hindfoot joint-sparing surgical procedures and its relationship with improvements in patient-reported outcome measures (PROMs) at latest follow-up. We hypothesized that significant deformity/PTS correction would be observed postoperatively, positively correlating with improved PROMs. METHODS: A prospective comparative study was performed with 26 flexible PCFD patients undergoing hindfoot joint-sparing reconstructive procedures, mean age 47.1 years (range, 18-77). We assessed weightbearing computed tomography (WBCT) overall deformity (foot and ankle offset [FAO]) and PTS markers (distance and coverage maps) at 3 months, as well as PROMs at final follow-up. A multivariate regression model assessed the influence of initial deformity correction and PTS optimization in patient-reported outcomes. RESULTS: Mean follow-up was 19.9 months (6-39), and the average number of procedures performed was 4.8 (2-8). FAO improved from 9.4% (8.4-10.9) to 1.9% (1.1-3.6) postoperatively (P < .0001). Mean coverage improved by 69.6% (P = .012), 12.1% (P = .0343) and 5.2% (P = .0074) in, respectively, the anterior, middle, and posterior facets, whereas the sinus tarsi coverage decreased by an average 57.1% (P < .0001) postoperatively. Improvements in patient-reported outcomes were noted for all scores assessed (P < .03). The multivariate regression analysis demonstrated that improvement in both FAO and PTS measurements significantly influenced the assessed PROMs. CONCLUSION: This study demonstrated significant improvements in the overall 3D deformity, PTS markers, and PROMs following hindfoot joint-sparing surgical treatment in patients with flexible PCFD. More importantly, initial 3D deformity correction and improvement in subtalar joint coverage and extraarticular impingement have been shown to influence PROMs significantly and positively. Addressing these variables should be considered as goals when treating PCFD. LEVEL OF EVIDENCE: Level II, prospective cohort study.

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Published In

Foot Ankle Int

DOI

EISSN

1944-7876

Publication Date

November 2023

Volume

44

Issue

11

Start / End Page

1128 / 1141

Location

United States

Related Subject Headings

  • Prospective Studies
  • Patient Reported Outcome Measures
  • Orthopedics
  • Middle Aged
  • Lower Extremity
  • Joint Dislocations
  • Humans
  • Foot Deformities
  • Flatfoot
  • 4207 Sports science and exercise
 

Citation

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de Cesar Netto, C., Barbachan Mansur, N. S., Lalevee, M., Carvalho, K. A. M. D., Godoy-Santos, A. L., Kim, K. C., … Dibbern, K. (2023). Effect of Peritalar Subluxation Correction for Progressive Collapsing Foot Deformity on Patient-Reported Outcomes. Foot Ankle Int, 44(11), 1128–1141. https://doi.org/10.1177/10711007231192479
Cesar Netto, Cesar de, Nacime Salomao Barbachan Mansur, Matthieu Lalevee, Kepler Alencar Mendes de Carvalho, Alexandre Leme Godoy-Santos, Ki Chun Kim, Francois Lintz, and Kevin Dibbern. “Effect of Peritalar Subluxation Correction for Progressive Collapsing Foot Deformity on Patient-Reported Outcomes.Foot Ankle Int 44, no. 11 (November 2023): 1128–41. https://doi.org/10.1177/10711007231192479.
de Cesar Netto C, Barbachan Mansur NS, Lalevee M, Carvalho KAMD, Godoy-Santos AL, Kim KC, et al. Effect of Peritalar Subluxation Correction for Progressive Collapsing Foot Deformity on Patient-Reported Outcomes. Foot Ankle Int. 2023 Nov;44(11):1128–41.
de Cesar Netto, Cesar, et al. “Effect of Peritalar Subluxation Correction for Progressive Collapsing Foot Deformity on Patient-Reported Outcomes.Foot Ankle Int, vol. 44, no. 11, Nov. 2023, pp. 1128–41. Pubmed, doi:10.1177/10711007231192479.
de Cesar Netto C, Barbachan Mansur NS, Lalevee M, Carvalho KAMD, Godoy-Santos AL, Kim KC, Lintz F, Dibbern K. Effect of Peritalar Subluxation Correction for Progressive Collapsing Foot Deformity on Patient-Reported Outcomes. Foot Ankle Int. 2023 Nov;44(11):1128–1141.
Journal cover image

Published In

Foot Ankle Int

DOI

EISSN

1944-7876

Publication Date

November 2023

Volume

44

Issue

11

Start / End Page

1128 / 1141

Location

United States

Related Subject Headings

  • Prospective Studies
  • Patient Reported Outcome Measures
  • Orthopedics
  • Middle Aged
  • Lower Extremity
  • Joint Dislocations
  • Humans
  • Foot Deformities
  • Flatfoot
  • 4207 Sports science and exercise