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Decreased Peritalar Subluxation in Progressive Collapsing Foot Deformity with Ankle Valgus Tilting.

Publication ,  Journal Article
Mansur, NSB; Lalevee, M; Shamrock, A; Lintz, F; de Carvalho, KAM; de Cesar Netto, C
Published in: JB JS Open Access
2023

BACKGROUND: Middle facet subluxation (MFS) has been established as an early indicator of peritalar subluxation. However, when progressive collapsing foot deformity (PCFD) affects the ankle leading to a valgus talar tilt (Class E), structures and anatomic relationships distal to the ankle joint may be affected. Therefore, this study aimed to assess radiographic parameters of peritalar subluxation in patients with PCFD who either did or did not have a valgus ankle. Our hypothesis was that these parameters would differ in Class E patients, upsetting their capability to quantify deformity. METHODS: We performed a prospective comparative study utilizing weight-bearing computed tomography (WBCT) images of 21 feet with PCFD and with valgus of the ankle and 64 with flexible PCFD without ankle involvement. Parameters including MFS, the medial cuneiform-to-floor distance, the forefoot arch angle, the talonavicular coverage angle, the hindfoot moment arm (HMA), the foot-ankle offset (FAO), and the talar tilt angle (TTA) were measured and compared. Variables that influence the presence of ankle valgus and overall alignment were assessed by multivariable regression models. RESULTS: Patients with PCFD and ankle valgus demonstrated a higher mean HMA (20.79 mm [95% confidence interval (CI), 17.56 to 24.02 mm] versus 8.94 mm [95% CI, 7.09 to 10.79 mm]), FAO (14.89% [95% CI, 12.51% to 17.26%] versus 6.32% [95% CI, 4.96% to 7.68%]) and TTA (95% CI, 17.10° [14.75° to 19.46°] versus 2.30° [95% CI, 0.94° to 3.65°]) and lower mean MFS (21.84% [95% CI, 15.04% to 28.63%] versus 38.45% [95% CI, 34.55% to 42.34%]) compared with the group without ankle valgus (p < 0.0001 for all). The FAO was influenced by MFS in the group without ankle valgus (p <0.0001) but not in the group with ankle valgus (p = 0.9161). FAO values of ≥12.14% were a strong predictor (79.2%) of ankle valgus deformity. CONCLUSIONS: Subluxation of the middle facet was not as severe and did not influence the overall alignment in patients with PCFD who had valgus of the ankle (Class E). These findings suggest a distal peritalar reduction in the presence of a proximal deformity, making MFS an imprecise disease parameter in this scenario. An FAO value of ≥12.14% was a strong indicator of ankle deformity in patients with PCFD. LEVEL OF EVIDENCE: Diagnostic Level II. See Instructions for Authors for a complete description of levels of evidence.

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Published In

JB JS Open Access

DOI

EISSN

2472-7245

Publication Date

2023

Volume

8

Issue

4

Location

United States

Related Subject Headings

  • 3202 Clinical sciences
 

Citation

APA
Chicago
ICMJE
MLA
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Mansur, N. S. B., Lalevee, M., Shamrock, A., Lintz, F., de Carvalho, K. A. M., & de Cesar Netto, C. (2023). Decreased Peritalar Subluxation in Progressive Collapsing Foot Deformity with Ankle Valgus Tilting. JB JS Open Access, 8(4). https://doi.org/10.2106/JBJS.OA.23.00025
Mansur, Nacime Salomao Barbachan, Matthieu Lalevee, Alan Shamrock, Francois Lintz, Kepler Alencar Mendes de Carvalho, and Cesar de Cesar Netto. “Decreased Peritalar Subluxation in Progressive Collapsing Foot Deformity with Ankle Valgus Tilting.JB JS Open Access 8, no. 4 (2023). https://doi.org/10.2106/JBJS.OA.23.00025.
Mansur NSB, Lalevee M, Shamrock A, Lintz F, de Carvalho KAM, de Cesar Netto C. Decreased Peritalar Subluxation in Progressive Collapsing Foot Deformity with Ankle Valgus Tilting. JB JS Open Access. 2023;8(4).
Mansur, Nacime Salomao Barbachan, et al. “Decreased Peritalar Subluxation in Progressive Collapsing Foot Deformity with Ankle Valgus Tilting.JB JS Open Access, vol. 8, no. 4, 2023. Pubmed, doi:10.2106/JBJS.OA.23.00025.
Mansur NSB, Lalevee M, Shamrock A, Lintz F, de Carvalho KAM, de Cesar Netto C. Decreased Peritalar Subluxation in Progressive Collapsing Foot Deformity with Ankle Valgus Tilting. JB JS Open Access. 2023;8(4).

Published In

JB JS Open Access

DOI

EISSN

2472-7245

Publication Date

2023

Volume

8

Issue

4

Location

United States

Related Subject Headings

  • 3202 Clinical sciences