635 results match your criteria Acquired Flatfoot


A Computational Model of Force within the Ligaments and Tendons in Progressive Collapsing Foot Deformity.

J Orthop Res 2022 May 17. Epub 2022 May 17.

Department of Orthopaedic Surgery, University of Arizona, Tucson, AZ.

Progressive collapsing foot deformity results from degeneration of the ligaments and posterior tibial tendon (PTT). Our understanding of the relationship between their failures remains incomplete. We sought to improve this understanding through computational modeling of the forces in these soft tissues. Read More

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Subtalar dislocation: a narrative review.

Musculoskelet Surg 2022 Apr 18. Epub 2022 Apr 18.

Department of Orthopaedics and Traumatology, Rovereto Hospital, Rovereto, Italy.

Background: Subtalar joint dislocation (1% of all dislocations) is the permanent loss of articular relationships in the talonavicular and talocalcaneal joints, without other involvement of the foot. Dislocation can occur medially (85%), laterally (15%), posteriorly (2.5%) and anteriorly (1%). Read More

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Soft Tissue Reconstruction and Osteotomies for Pes Planovalgus Correction.

Clin Podiatr Med Surg 2022 Apr;39(2):207-231

Board Certified, Foot & Ankle Reconstructive Surgery, Orthopedic Foot & Ankle Center, Columbus, OH, USA; Orthopedic Foot & Ankle Center, 350 West Wilson Bridge Road, Suite 200, Worthington, OH 43085, USA.

The correction of the flexible pes planovalgus foot and ankle is a complicated and somewhat controversial topic. After conservative methods fail, there is a wide range of possible soft tissue and bony procedures. The appropriate work up and understanding of the pathomechanics are vital to the correct choice of procedures to correct these deformities. Read More

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Different Design Feature Combinations of Flatfoot Orthosis on Plantar Fascia Strain and Plantar Pressure: A Muscle-Driven Finite Element Analysis With Taguchi Method.

Front Bioeng Biotechnol 2022 10;10:853085. Epub 2022 Mar 10.

Department of Biomedical Engineering, Faculty of Engineering, Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China.

Customized foot orthosis is commonly used to modify foot posture and relieve foot pain for adult acquired flexible flatfoot. However, systematic investigation of the influence of foot orthotic design parameter combination on the internal foot mechanics remains scarce. This study aimed to investigate the biomechanical effects of different combinations of foot orthoses design features through a muscle-driven flatfoot finite element model. Read More

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Enhancement of evaluating flatfoot on a weight-bearing lateral radiograph of the foot with U-Net based semantic segmentation on the long axis of tarsal and metatarsal bones in an active learning manner.

Comput Biol Med 2022 Jun 14;145:105400. Epub 2022 Mar 14.

Department of Convergence Medicine, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. Electronic address:

Robust labeling for semantic segmentation in radiographs is labor-intensive. No study has evaluated flatfoot-related deformities using semantic segmentation with U-Net on weight-bearing lateral radiographs. Here, we evaluated the robustness, accuracy enhancement, and efficiency of automated measurements for flatfoot-related angles using semantic segmentation in an active learning manner. Read More

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The impact of ligament tears on joint contact mechanics in progressive collapsing foot deformity: A finite element study.

Clin Biomech (Bristol, Avon) 2022 Apr 18;94:105630. Epub 2022 Mar 18.

Department of Orthopaedic Surgery, University of Arizona, Tucson, AZ, USA. Electronic address:

Background: Patients with longstanding progressive collapsing foot deformity often develop osteoarthritis of the ankle, midfoot, or hindfoot joints, which can be symptomatic or lead to fixed deformities that complicate treatment. The development of deformity is likely caused by ligament degeneration and tears. However, the effect of individual ligament tears on changes in joint contact mechanics has not been investigated. Read More

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Diagnostic Accuracy of the Progressive Collapsing Foot Deformity (PCFD) Classification.

Foot Ankle Int 2022 Mar 18:10711007221078000. Epub 2022 Mar 18.

Department of Orthopaedic Surgery, University of Colorado School of Medicine, Denver, CO, USA.

Background: A consensus group recently proposed the term (PCFD) and a new classification with 2 stages plus 5 classes to describe the complex array of flatfoot deformities. This study aimed to validate different diagnostic accuracy rates of the PCFD classification.

Methods: This was a survey-based study distributed among 13 foot and ankle fellowship programs for 3 groups of participants with varied experience in practice (group 1: fellows in training, group 2: surgeons in practice for 1-4 years, and group 3: surgeons in practice for ≥5 years). Read More

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Letter to the editor regarding "Finite element analysis of subtalar joint arthroereisis on adult-acquired flexible flatfoot deformity using customised sinus tarsi implant".

J Orthop Translat 2022 Mar 3;33:70-71. Epub 2022 Mar 3.

Department of Orthopaedics, Shanghai Jiao Tong University Affiliated Sixth Peoples Hospital, Shanghai, 200233, China.

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Adult-Acquired Flatfoot Deformity: Combined Talonavicular Arthrodesis and Calcaneal Displacement Osteotomy versus Double Arthrodesis.

J Clin Med 2022 Feb 5;11(3). Epub 2022 Feb 5.

Department for Trauma and Orthopaedic Surgery Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, 60389 Frankfurt, Germany.

Background: Adult-acquired flatfoot deformity due to posterior tibial tendon dysfunction (PTTD) is one of the most common foot deformities among adults.

Hypothesis: Our study aimed to confirm that the combined procedures of calcaneal displacement osteotomy and talonavicular arthrodesis are equivalent to double arthrodesis.

Methods: Between 2016 and 2020, 41 patients (13 male and 28 females, mean age of 63 years) were retrospectively enrolled in the comparative study. Read More

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February 2022

Calcaneal offset index to measure hindfoot alignment in pes planus.

Skeletal Radiol 2022 Feb 10. Epub 2022 Feb 10.

Departments of Musculoskeletal Radiology, Royal Orthopaedic Hospital, Bristol Road South, Birmingham, B21 3AP, UK.

Introduction: Pes planus is a common three-dimensional (3D) deformity characterised by forefoot abduction, the collapse of the medial longitudinal arch, and hindfoot valgus. Several radiological measurements such as anteroposterior talocalcaneal angle (Kite's) and 'Calcaneal pitch angle' (CPA) exist to calculate the degree of hindfoot alignment in these patients with variable intra- and interobserver reliability.

Objective: To describe a new radiological ancillary method of measuring hindfoot alignment, the calcaneal offset index (COI). Read More

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February 2022

18-Year Operative Incidence and Cost Analysis of the Treatment of Adult Acquired Flatfoot Deformity.

Foot Ankle Orthop 2021 Jan 19;6(1):2473011420985864. Epub 2021 Feb 19.

Department of Orthopaedic Surgery, University of South Carolina School of Medicine, Columbia, SC, USA.

Background: Adult acquired flatfoot (AAFD) is commonly treated by foot and ankle surgeons. Despite how commonly this disease presents, its incidence and economic impact have yet to be defined. We hypothesized that the operative incidence of AAFD and its economic burden would increase over the time period 1996 to 2014. Read More

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January 2021

Radiographic Outcomes of Talonavicular Joint Arthrodesis With Varying Fixation Techniques in Stage III Adult Acquired Flatfoot Reconstruction.

J Foot Ankle Surg 2021 Dec 20. Epub 2021 Dec 20.

Director of Residency Training Division of Foot and Ankle Surgery, West Penn Hospital, Allegheny Health Network, Pittsburgh, PA. Electronic address:

Utilization of the talonavicular joint (TN) arthrodesis as an isolated procedure or in combination with hindfoot arthrodesis has been described in the literature for treatment of numerous hindfoot conditions. When used in isolation or with concomitant hindfoot arthrodesis, the TN joint has demonstrated nonunion rates reported as high as 37% in the literature. Despite previous research, there remains a lack of agreement upon the ideal fixation technique for TN joint arthrodesis with and without concomitant subtalar joint arthrodesis. Read More

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December 2021

Radiographic Outcomes of Isolated Subtalar Joint Arthrodesis With Varying Fixation Technique.

J Foot Ankle Surg 2021 Dec 18. Epub 2021 Dec 18.

Director of Residency Training, Division of Foot and Ankle Surgery, West Penn Hospital, Allegheny Health Network, Pittsburgh, PA. Electronic address:

Subtalar joint (STJ) arthrodesis is a well-established and accepted surgical procedure utilized for the treatment of various hindfoot conditions including primary or posttraumatic subtalar osteoarthritis, hindfoot valgus deformity, hindfoot varus deformity, complex acute calcaneal fracture, symptomatic residual congenital deformity, tarsal coalition, and other conditions causing pain and deformity about the hindfoot. Union rates associated with isolated subtalar joint arthrodesis are generally thought to be favorable, though reports have varied significantly, with non-union rates ranging from 0 to 46%. Various fixation constructs have been recommended for STJ arthrodesis. Read More

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December 2021

Radiographic Analysis and Clinical Efficacy of Hindfoot Arthrodesis With Versus Without Cotton Osteotomy in Stage III Adult Acquired Flatfoot Deformity.

J Foot Ankle Surg 2021 Dec 12. Epub 2021 Dec 12.

Director of Residency Training, Division of Foot and Ankle Surgery, West Penn Hospital, Allegheny Health Network, Pittsburgh, PA. Electronic address:

Forefoot varus develops as a result of longstanding adult-acquired flatfoot deformity (AAFD). This occurs with varying degrees of deformity and flexibility. Residual forefoot varus following hindfoot realignment in AAFD can lead to lateral column loading and a persistent pronatory moment in efforts to reestablish contact between the forefoot and the ground. Read More

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December 2021

The contribution of the ligaments in progressive collapsing foot deformity: A comprehensive computational study.

J Orthop Res 2022 Jan 3. Epub 2022 Jan 3.

Department of Orthopaedic Surgery, University of Arizona, Tucson, Arizona, USA.

The contribution of each of the ligaments in preventing the arch loss, hindfoot valgus, and forefoot abduction seen in progressive collapsing foot deformity (PCFD) has not been well characterized. An improved understanding of the individual ligament contributions to the deformity would aid in selecting among available treatments, optimizing current surgical techniques, and developing new ones. In this study, we evaluated the contribution of each ligament to the maintenance of foot alignment using a finite element model of the foot reconstructed from computed tomography scan images. Read More

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January 2022

Short- to Intermediate-Term Radiographic Outcomes Following Cotton Osteotomy.

J Foot Ankle Surg 2021 Dec 21. Epub 2021 Dec 21.

Podiatric Medicine and Surgery Residency, University of Pittsburgh Medical Center Mercy, Pittsburgh, PA; Department of Orthopaedic Surgery, University Pittsburgh School of Medicine, Pittsburgh, PA.

The cotton osteotomy or the medial cuneiform opening wedge osteotomy has been a common adjunct procedure in flatfoot reconstruction to correct for forefoot varus or a dorsiflexed first ray. The main goal of the study is to retrospectively review outcomes specifically in the short-intermediate term for the cotton osteotomy. The medical records of a single foot and ankle surgeon (PRB) were reviewed for patients who met inclusion and exclusion criteria. Read More

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December 2021

Isolated medial column stabilization surgery does not benefit adult acquired flatfoot stage IIa nor IIb by three-dimensional finite element biomechanical analysis.

Am J Transl Res 2021 15;13(11):12834-12842. Epub 2021 Nov 15.

Department of Sports Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital Shenzhen, Guangdong, China.

The surgical treatment for stage II adult acquired flat foot deformity (AAFD) remains controversial. Biomechanical effects of medial column stabilization remain unclear. No study has biomechanically assessed the effect of medial column arthrodesis on the whole foot. Read More

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November 2021

The role of medial ligaments and tibialis posterior in stabilising the medial longitudinal foot arch: a cadaveric gait simulator study.

Foot Ankle Surg 2021 Dec 21. Epub 2021 Dec 21.

Department of Human Movement Sciences, KU Leuven, Leuven, Belgium. Electronic address:

Background: Debate exists whether adult acquired flatfoot deformity develops secondary to tibialis posterior (TibPost) tendon insufficiency, failure of the ligamentous structures, or a combination of both.

Aim: The aim of this study is to determine the contribution of the different medial ligaments in the development of acquired flatfoot pathology. Also to standardise cadaveric flatfoot models for biomechanical research and orthopaedic training. Read More

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December 2021

Adult Acquired Flatfoot Deformity.

J Am Acad Orthop Surg 2022 Jan;30(1):e6-e16

From the University of South Carolina School of Medicine Department of Orthopedic Surgery Prisma Health, Columbia, SC.

Adult acquired flatfoot deformity (AAFD) is a condition commonly seen by orthopaedic surgeons. Posterior tibial tendon dysfunction is thought to be the initial pathoanatomic etiology that leads to this deformity. Successful resolution of the pain associated with AAFD can be achievable with nonsurgical methods. Read More

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January 2022

A comparison between the Bluman et al. and the progressive collapsing foot deformity classifications for flatfeet assessment.

Arch Orthop Trauma Surg 2021 Dec 3. Epub 2021 Dec 3.

Department of Orthopedics and Rehabilitation, Carver College of Medicine, University of Iowa, 200 Hawkins Dr, John PappaJohn Pavillion (JPP), Room 01066, Lower Level, Iowa City, IA, 52242, USA.

Introduction: Bluman et al., flatfoot classification is based on posterior tibial tendon (PTT) dysfunction leading to a chronological appearance of several foot deformities. An expert consensus recently proposed a new classification named Progressive Collapsing Foot Deformity (PCFD) in which the focus was shifted to five different independent foot and ankle deformities and their flexibility or rigidity. Read More

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December 2021

The Plantar Fascia Talar Head Correlation: A Radiographic Parameter With a Distinct Threshold to Validate Flatfoot Deformity and Its Corrective Surgery on Conventional Weightbearing Radiographs.

Foot Ankle Int 2022 Mar 20;43(3):414-425. Epub 2021 Nov 20.

Department of Radiology, Klinik Birshof Hirslanden AG, Münchenstein, Switzerland.

Background: Corrective surgery for flexible flatfoot deformity (FD) remains controversial, and one of the main reasons for this is the lack of standardized radiographic measurements to define an FD. Previously published radiographic parameters to differentiate between a foot with and without an FD do not have a commonly accepted and distinct threshold.

Methods: The plantar fascia-talar head correlation (PTC) with its defined threshold was assessed by measuring the distance between the medial border of the plantar fascia and the center of the talar head (DPT) on conventional dorsoplantar and lateral weightbearing radiographs; the authors were blinded to the clinical diagnosis of the 189 patients' first visits. Read More

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Effects of Plyometric Exercises versus Flatfoot Corrective Exercises on Postural Control and Foot Posture in Obese Children with a Flexible Flatfoot.

Appl Bionics Biomech 2021 31;2021:3635660. Epub 2021 Oct 31.

Department of Biomechanics, Faculty of Physical Therapy, Cairo University, Egypt.

Background: Obesity contributes to the acquired flatfoot deformity which in turn impairs balance.

Aim: The purpose of the current study was to compare the effect of plyometric exercises with flatfoot corrective exercises on balance, foot posture, and functional mobility in obese children with a flexible flatfoot.

Methods: Forty-seven children participated in the study. Read More

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October 2021

Bony Procedures for Correction of the Flexible Pediatric Flatfoot Deformity.

Foot Ankle Clin 2021 Dec 14;26(4):915-939. Epub 2021 Oct 14.

Division of Orthopaedic Surgery, The University of Toronto, 500 University Avenue #602, Toronto, Ontario M5G 1V7, Canada.

The pediatric flexible flatfoot is a common foot shape that is most often asymptomatic and may be a physiologic variant of normal. Surgery is only indicated when nonoperative interventions have failed to resolve symptoms. The goal of surgery is to alleviate symptoms by improving hindfoot alignment and restoring the medial arch while preserving joint mobility. Read More

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December 2021

A Modified Extra-articular Lateral Column Lengthening Procedure for Adult Acquired Flatfoot Deformity.

Foot Ankle Int 2022 04 5;43(4):520-528. Epub 2021 Nov 5.

Department of Orthopedic Surgery, National Taiwan University Hospital, Taipei City, Taiwan.

Background: Lateral column lengthening (LCL), originally described by Evans, is an established procedure to correct stage II adult acquired flatfoot deformity (AAFD). However, the relative position between the facets is violated, and other problems may include nonunion, malunion, and calcaneocuboid (CC) joint subluxation. Herein, we report a modified extra-articular technique of LCL with hockey-stick osteotomy, which preserves the subtalar joint as a whole, increases bony apposition to enhance healing ability, and preserves the insertion of the calcaneofibular ligament to stabilize the posterior fragment to promote adduction of the forefoot. Read More

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Imaging of progressive collapsing foot deformity with emphasis on the role of weightbearing cone beam CT.

Skeletal Radiol 2022 Jun 25;51(6):1127-1141. Epub 2021 Oct 25.

Lab. Prof. Manlio Mario Marco Napoli, Faculdade de Medicina, Universidade de São Paulo, R. Ovidio Pires de Campos, 333, São Paulo, SP, 05403-010, Brazil.

The term progressive collapsing foot deformity (PCFD) is currently recommended as the replacement to adult-acquired flatfoot deformity and posterior tibial tendon dysfunction to better reflect its pathology, which consists of a complex three-dimensional deformity involving the foot and ankle. The new consensus has also provided a new classification that requires clinical and radiographic findings for patient stratification into each class. However, conventional radiographs are susceptible to errors resulting from the inadequate positioning of patients, incorrect angulation of the X-ray tube, and overlapping of bone structures. Read More

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Patient Outcomes Following Extra-Osseous Talo-Tarsal Stabilization for Foot Hyperpronation.

J Foot Ankle Surg 2022 Mar-Apr;61(2):318-322. Epub 2021 Sep 9.

Department of Orthopedic Surgery, University Medical Centre Ljubljana, Ljubljana, Slovenia; Chair of Orthopedics, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.

The aim is to present a single-center case series of patients with symptomatic hyperpronated feet treated with arthroereisis by using a second generation extra-osseous talo-tarsal stabilization device. This case series enrolled 123 feet in 87 patients (20 [6-75] years) treated with arthroereisis, either isolated (76 cases) or combined procedure (47 cases). At their final follow-up, a patient reported questionnaire (overall satisfaction, foot stability and shape, activities of daily living, pain level, and analgesics usage) was distributed. Read More

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Biomechanical comparison among five mid/hindfoot arthrodeses procedures in treating flatfoot using a musculoskeletal multibody driven finite element model.

Comput Methods Programs Biomed 2021 Nov 9;211:106408. Epub 2021 Sep 9.

Department of Biomedical Engineering, Faculty of Engineering, Hong Kong Polytechnic University, Hong Kong SAR 999077, China; Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen 518057, China. Electronic address:

Background And Objective: Mid/hindfoot arthrodesis could modify the misalignment of adult-acquired flatfoot and attenuate pain. However, the long-term biomechanical effects of these surgical procedures remain unclear, and the quantitative evidence is scarce. Therefore, we aimed to investigate and quantify the influences of five mid/hindfoot arthrodeses on the internal foot biomechanics during walking stance. Read More

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November 2021

[Acquired flat foot of the adult by posterior tibial dysfunction. Options for surgical treatment].

Acta Ortop Mex 2021 Jan-Feb;35(1):92-117

División de Pie y Tobillo y DNM del Instituto Nacional de Rehabilitación. Ciudad de México.

We present the possible etiopatogenic causes of posterior tibial dysfunction or painful flat foot of the adult and the cause-and-effect relationship that may exist. We also expose the gradation of the lesion and the different therapeutic options for the surgical treatment of the deformity. Since 1939, multiple articles have been published, which have been endorsed by clinical, experimental, electromyographic and biomechanical studies; publications that have been consulted and evaluated for the development of this review. Read More

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September 2021