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

PCFD distance mapping flatfoot joint coverage peritalar subluxation progressive collapsing foot deformity weightbearing CT

Journal

Foot & ankle international
ISSN: 1944-7876
Titre abrégé: Foot Ankle Int
Pays: United States
ID NLM: 9433869

Informations de publication

Date de publication:
Nov 2023
Historique:
medline: 30 11 2023
pubmed: 12 9 2023
entrez: 12 9 2023
Statut: ppublish

Résumé

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. 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. 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 ( 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 II, prospective cohort study.

Sections du résumé

BACKGROUND UNASSIGNED
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 UNASSIGNED
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 UNASSIGNED
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 (
CONCLUSION UNASSIGNED
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 UNASSIGNED
Level II, prospective cohort study.

Identifiants

pubmed: 37698292
doi: 10.1177/10711007231192479
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1128-1141

Déclaration de conflit d'intérêts

Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. ICMJE forms for all authors are available online.

Auteurs

Cesar de Cesar Netto (C)

Department of Orthopedics and Rehabilitation, Carver College of Medicine, University of Iowa (UIOWA), Iowa City, IA, USA.

Nacime Salomao Barbachan Mansur (NS)

Department of Orthopedics and Rehabilitation, Carver College of Medicine, University of Iowa (UIOWA), Iowa City, IA, USA.
Department of Orthopedics and Traumatology, Escola Paulista de Medicina, UNIFESP, São Paulo, Brazil.

Matthieu Lalevee (M)

Department of Orthopedics and Rehabilitation, Carver College of Medicine, University of Iowa (UIOWA), Iowa City, IA, USA.
Service d'orthopédie Traumatologie, Centre Hospitalier Universitaire de Rouen, Rouen, France.

Kepler Alencar Mendes de Carvalho (KAM)

Department of Orthopedics and Rehabilitation, Carver College of Medicine, University of Iowa (UIOWA), Iowa City, IA, USA.

Alexandre Leme Godoy-Santos (AL)

Department of Orthopedics and Traumatology, University of Sao Paulo, Sao Paulo, Brazil.

Ki Chun Kim (KC)

Department of Orthopedics and Rehabilitation, Carver College of Medicine, University of Iowa (UIOWA), Iowa City, IA, USA.
Department of Orthopaedic Surgery, Seoul Medical Center, Seoul, Republic of Korea.

Francois Lintz (F)

Clinique de L'Union, Saint-Jean, France.

Kevin Dibbern (K)

Department of Orthopedics and Rehabilitation, Carver College of Medicine, University of Iowa (UIOWA), Iowa City, IA, USA.
Marquette University, Milwaukee, WI, USA.

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