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Correction of progressive collapsing foot deformity classes after isolated arthroscopic subtalar arthrodesis.
Bernasconi, Alessio; Lalevée, Matthieu; Fernando, Céline; Izzo, Antonio; de Cesar Netto, Cesar; Lintz, François.
Afiliación
  • Bernasconi A; Department of Public Health, Orthopaedic and Traumatology Unit, University Federico II of Naples, Naples, Italy. Electronic address: alessio.bernasconi@unina.it.
  • Lalevée M; CETAPS UR 3832, Research Center for Sports and Athletic Activities Transformations, University of Rouen Normandy, Mont-Saint-Aignan F-76821, France; Rouen University Hospital, Orthopedic and Trauma Surgery Department, 37 Boulevard Gambetta, Rouen 76000, France.
  • Fernando C; Ramsay Santé Clinique de l'Union, Centre de Chirurgie de la Cheville et du Pied, Saint Jean, France.
  • Izzo A; Department of Public Health, Orthopaedic and Traumatology Unit, University Federico II of Naples, Naples, Italy.
  • de Cesar Netto C; Foot and Ankle Division, Duke University, Durham, NC, United States.
  • Lintz F; Ramsay Santé Clinique de l'Union, Centre de Chirurgie de la Cheville et du Pied, Saint Jean, France.
Foot Ankle Surg ; 2024 Jul 07.
Article en En | MEDLINE | ID: mdl-39019688
ABSTRACT

INTRODUCTION:

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 (2 A according to PCFD classification) and/or peritalar subluxation (2D) with or without associated flexible midfoot and/or forefoot deformities (1B, 1 C 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 in the study. Preoperative medial facet subluxation was 28.3 % (IQR, 15.1 to 49.3 %). Overall PCFD 3D deformity improved with a reduction of the foot and ankle offset from 9.3 points (IQR, 7.8 to 12) to 4 (IQR, 0.9 to 7) (p < 0.001). Class A-hindfoot valgus (median tibiocalcaneal angle and median calcaneal moment arm improved by 9.4 degrees (p < 0.001) and 11 mm (p < 0.001), respectively), class B-midfoot abduction (median talonavicular coverage angle improved by 20.5 degrees, p < 0.001) and class C-forefoot varus (median sagittal talo-first metatarsal angle improved by 10.2 degrees (p < 0.001)) were significantly corrected after surgery. Class D was difficult to assess due to the fusion procedure. No patient had a pre-operative valgus deformity at the ankle (no 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. LEVEL OF EVIDENCE Level IV, case series.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Foot Ankle Surg Asunto de la revista: ORTOPEDIA Año: 2024 Tipo del documento: Article Pais de publicación: Francia
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Foot Ankle Surg Asunto de la revista: ORTOPEDIA Año: 2024 Tipo del documento: Article Pais de publicación: Francia