Three-Dimensional Distance and Coverage Maps in the Assessment of Peritalar Subluxation in Progressive Collapsing Foot Deformity

Dibbern, Kevin; Li, Shuyuan; Vivtcharenko, Victoria; Auch, Elijah; Lintz, François; Ellis, Scott J.; Femino, John E.

doi:10.1177/1071100720983227

Cited by 40 publications

(55 citation statements)

References 29 publications

(46 reference statements)

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“…In other words, an FAO higher than 6.33% might suggest a higher degree of peritalar subluxation. 7,8 Interestingly, in patients with an FAO greater than 6.33%, a BMI higher than 43.12 was found to be a predictor of higher MF subluxation and PTS. This observation augments the idea that obesity may play a role in further aggravation of the disease.…”

Section: Discussionmentioning

confidence: 92%

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Association Between Middle Facet Subluxation and Foot and Ankle Offset in Progressive Collapsing Foot Deformity

et al. 2021

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Background: Subtalar middle facet (MF) subluxation was recognized as a reliable marker for progressive collapsing foot deformity (PCFD) diagnosis. Foot and Ankle Offset (FAO) is an established measurement, predictive of malalignment severity. The objective of this study was to assess the potential association between MF subluxation and FAO in PCFD patients. Methods: 56 individuals with flexible PCFD (74 feet) were assessed. Two blinded foot and ankle surgeons calculated MF uncoverage, MF incongruence, and FAO. Agreement was quantified using intraclass correlation coefficient (ICC). A multivariate regression analysis and partition prediction models were applied to assess relationship between values. Results: All ICCs were >0.80. MF subluxation and FAO were found to be correlated ( rs = 0.56; P < .0001). Changes in the MF subluxation were noticeably explained by FAO and BMI ( R2 = 0.33). MF incongruence was not correlated with the assessed variables ( P = .10). In this cohort, an MF subluxation of 27.5% was a threshold for increased FAO (FAO of 3.4%±2.4% when below; FAO of 8.0% ±3.5% when above). Conclusion: We found a correlation between MF subluxation and FAO. An MF subluxation of 27.5% was found to be a threshold for higher FAO, which corresponded to a greater malalignment. These data may help surgeons optimize treatment decisions in PCFD patients. Level of Evidence: Level III, retrospective comparative study.

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Section: Discussionmentioning

confidence: 92%

“…In other words, an FAO higher than 6.33% might suggest a higher degree of peritalar subluxation. 7,8…”

Section: Discussionmentioning

confidence: 99%

Association Between Middle Facet Subluxation and Foot and Ankle Offset in Progressive Collapsing Foot Deformity

et al. 2021

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“…In the last decade, WBCT became a well-established imaging method to assess alignment and different pathologies of the foot and ankle. [12][13][14][15]25 However, only few other studies have used imaging to evaluate the relationship between hindfoot and forefoot alignment. Kim et al 19 retrospectively evaluated WBPRs of 163 patients and compared patients with juvenile hallux valgus to a control cohort to determine whether a pes planovalgus deformity was associated with juvenile hallux valgus.…”

Section: Discussionmentioning

confidence: 99%

Association Between Hindfoot Alignment and First Metatarsal Rotation

et al. 2021

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Background: The association between forefoot and hindfoot position for planus and cavus feet is fundamental to the treatment of these deformities. However, no studies have evaluated the association between hindfoot alignment and first metatarsal (M1) axial rotation. Understanding this possible relationship may help to understand the deformity and improve patient care. The purpose of this study is to determine a correlation between hindfoot alignment and metatarsal rotation as assessed by weightbearing computed tomography (WBCT). Methods: Patients who underwent weightbearing plain radiography (WBPR) and WBCT between 2015 and 2018 were evaluated. Hindfoot alignment was measured with the calcaneal moment arm (CMA). M1 rotation was measured using the Kim and Saltzman angles. Patient subgroups were created according to the severity of valgus/varus hindfoot alignment. Statistical analyses were performed to evaluate for association between variables. Results: Among the 196 patient feet included in the study, the average CMA was 6.0 ± 16.2 mm. The average Kim and Saltzman angles were 7.7 ± 12.9 degrees and 2.8 ± 13.1 degrees, respectively. The average Meary angle was 182.0 ± 11.9 degrees. A moderately strong association was found between the CMA and the Saltzman ( r = 0.641, P < .01) and Kim angles ( r = 0.615, P < .01). Hindfoot valgus was associated with M1 pronation and hindfoot varus with M1 supination. Additionally, inverse relationships between the Meary angle and the Saltzman ( r = −0.600, P < .01) and Kim angles ( r = −0.529, P < .01) were identified. Conclusion: In this well-defined cohort, we found substantial correlation between hindfoot alignment and M1 rotation. Hindfoot valgus was associated with M1 pronation, and hindfoot varus was associated with M1 supination. Surgeons correcting cavovarus/planovalgus deformities should be aware of this association and evaluate the need for first-ray derotation. Level of Evidence: Level III, retrospective cohort study.

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“…The angle measurement and arch height of the models were similar to those of the PCFD population. 3,9,12,13,25,31,32,39,41,47 The comparison results between the rectangle and triangular grafts suggested that the correcting ability of rectangle grafts was stronger than that of triangular grafts. However, the contact characteristics of the calcaneocuboid joint and talonavicular joint were abnormal, whereas the strain of the spring ligament even increased.…”

Section: Discussionmentioning

confidence: 99%

Biomechanical Effects of Graft Shape for the Evans Lateral Column Lengthening Procedure: A Patient-Specific Finite Element Investigation

Hua

2021

Foot Ankle Int.

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Background: The Evans calcaneal lengthening osteotomy procedure is widely used for correcting progressive collapsing foot deformity. However, it can result in overcorrection and degenerations of the calcaneocuboid joint. Different shapes of graft have been used in the Evans calcaneal osteotomy, but potential differences in their biomechanical effects is still unclear. The present study was designed to explore the biomechanical effects of graft shape and improve the Evans procedure to avoid or minimize detrimental effects. Methods: Twelve patient-specific finite element models were established and validated. A triangular or rectangular wedge of varying size was inserted at the lateral edge of calcaneus, and the degree of correction was quantified. The stress in spring ligaments and plantar fascia and the contact characteristics of the talonavicular and calcaneocuboid joints were calculated and compared accordingly. Results: The rectangular graft provided a much higher degree of correction than triangular grafts did. However, the contact characteristics of the calcaneocuboid joint and talonavicular joint were abnormal, with clear sensitivity to increased graft size, and the modeled strain of the spring ligament increased. Conclusion: The finite element analysis predicts that the rectangular grafts provide a higher degree of correction, but risks overcorrection compared with triangular grafts. The triangular graft may have a lower degree of disturbance to the biomechanical behaviors of the midtarsal joint. Clinical Relevance: The model shows that both the shape and size of an Evans osteotomy bone wedge can have effects on the contiguous joints and ligamentous structures. Those effects should be considered when selecting a bone wedge for an Evans calcaneal osteotomy. Level of Evidence: Level III, case-control study.

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Three-Dimensional Distance and Coverage Maps in the Assessment of Peritalar Subluxation in Progressive Collapsing Foot Deformity

Cited by 40 publications

References 29 publications

Association Between Middle Facet Subluxation and Foot and Ankle Offset in Progressive Collapsing Foot Deformity

Association Between Middle Facet Subluxation and Foot and Ankle Offset in Progressive Collapsing Foot Deformity

Association Between Hindfoot Alignment and First Metatarsal Rotation

Biomechanical Effects of Graft Shape for the Evans Lateral Column Lengthening Procedure: A Patient-Specific Finite Element Investigation

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