A multiple joint morphometric analysis of female patients with progressive collapsing foot deformity: a cross-sectional study.

Abstract

Progressive collapsing foot deformity is a complex clinical presentation of combined deformities, which affects articular joint relationships. Herein, the study aimed to characterize joint interactions of the ankle, tibiofibular, talofibular, subtalar, talonavicular, calcaneocuboid, naviculo-cuneiform, and tarso-metatarsal joints. We quantified and compared the results between 23 female patients with progressive collapsing foot deformity and 23 female asymptomatic individuals. We used a multi-domain correspondence model from statical shape modeling to compare the alignment and morphology followed by calculating the joint-level measurements including the joint space distance and the congruence index between groups. From our results we found that almost all bones and joints were affected by the progressive collapsing foot deformity. Our main results for joint space distances were narrowing in the sinus tarsi, gapping at the medial of the calcaneocuboid joint, and narrowing at the 3rd, 4th, and 5th tarso-metatarsal joints. The primary results for the congruence index were shifted to the lateral side in the talonavicular joint and a less congruent middle facet of the subtalar joint in the progressive collapsing foot deformity group. In addition, the joint space distance was mainly influenced by alignment, and the congruence index was influenced by bone morphology. We believe that assessing multi-joint interactions in progressive collapsing foot deformity will lead to a better understanding of the pathophysiology and assist in surgical treatment planning.