Progressive collapsing foot deformity: short and mid-term correction with arthroereisis compared with lateral column lengthening.

Abstract

Progressive collapsing foot deformity (PCFD) grade I AB can cause progressive structural changes and functional limitations. Surgical intervention is indicated when deformity progression or symptoms significantly impair daily activities. To compare the effectiveness of lateral column lengthening (LCL) and subtalar arthroereisis (STA) in the surgical treatment of early-stage PCFD. Retrospective comparative study. Fifty-six patients with grade I AB PCFD were reviewed retrospectively; 16 underwent STA and 40 underwent LCL combined with medializing calcaneal osteotomy and medial soft tissue procedures. All radiographic measurements were performed by a single surgeon not involved in the surgeries. Primary outcomes were changes in angular parameters and American Orthopaedic Foot and Ankle Society (AOFAS) scores. Mean follow-up was 28.6 months (range, 18-72 months). Preoperative functional scores averaged 47.15 points, improving to 98.3 points postoperatively. Both techniques achieved statistically significant improvements in most angular parameters and functional scores. The Costa-Bartani angle did not significantly change in the STA group. No statistically significant differences were observed between groups in postoperative angular correction or functional scores. Patients aged 42-65 years showed greater improvements in the lateral talocalcaneal angle compared to other age groups, suggesting a possible age-related influence on certain radiographic outcomes. Both LCL and STA are effective surgical options for the management of early-stage PCFD, producing significant radiographic and functional improvements. Age may influence specific radiographic parameters, warranting further investigation.