{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:41:54Z","timestamp":1787755314878,"version":"build-2784847793"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2023,10,1]],"date-time":"2023-10-01T00:00:00Z","timestamp":1696118400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Middle facet subluxation (MFS) has been established as an early indicator of peritalar subluxation. However, when progressive collapsing foot deformity (PCFD) affects the ankle leading to a valgus talar tilt (Class E), structures and anatomic relationships distal to the ankle joint may be affected. Therefore, this study aimed to assess radiographic parameters of peritalar subluxation in patients with PCFD who either did or did not have a valgus ankle. Our hypothesis was that these parameters would differ in Class E patients, upsetting their capability to quantify deformity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We performed a prospective comparative study utilizing weight-bearing computed tomography (WBCT) images of 21 feet with PCFD and with valgus of the ankle and 64 with flexible PCFD without ankle involvement. Parameters including MFS, the medial cuneiform-to-floor distance, the forefoot arch angle, the talonavicular coverage angle, the hindfoot moment arm (HMA), the foot-ankle offset (FAO), and the talar tilt angle (TTA) were measured and compared. Variables that influence the presence of ankle valgus and overall alignment were assessed by multivariable regression models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Patients with PCFD and ankle valgus demonstrated a higher mean HMA (20.79 mm [95% confidence interval (CI), 17.56 to 24.02 mm] versus 8.94 mm [95% CI, 7.09 to 10.79 mm]), FAO (14.89% [95% CI, 12.51% to 17.26%] versus 6.32% [95% CI, 4.96% to 7.68%]) and TTA (95% CI, 17.10\u00b0 [14.75\u00b0 to 19.46\u00b0] versus 2.30\u00b0 [95% CI, 0.94\u00b0 to 3.65\u00b0]) and lower mean MFS (21.84% [95% CI, 15.04% to 28.63%] versus 38.45% [95% CI, 34.55% to 42.34%]) compared with the group without ankle valgus (p &lt; 0.0001 for all). The FAO was influenced by MFS in the group without ankle valgus (p &lt;0.0001) but not in the group with ankle valgus (p = 0.9161). FAO values of \u226512.14% were a strong predictor (79.2%) of ankle valgus deformity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Subluxation of the middle facet was not as severe and did not influence the overall alignment in patients with PCFD who had valgus of the ankle (Class E). These findings suggest a distal peritalar reduction in the presence of a proximal deformity, making MFS an imprecise disease parameter in this scenario. An FAO value of \u226512.14% was a strong indicator of ankle deformity in patients with PCFD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Diagnostic\n                      <jats:underline>Level II<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.oa.23.00025","type":"journal-article","created":{"date-parts":[[2023,10,27]],"date-time":"2023-10-27T14:10:48Z","timestamp":1698415848000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["Decreased Peritalar Subluxation in Progressive Collapsing Foot Deformity with Ankle Valgus Tilting"],"prefix":"10.2106","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1067-727X","authenticated-orcid":false,"given":"Nacime Salomao Barbachan","family":"Mansur","sequence":"first","affiliation":[{"name":"Department of Orthopedics and Rehabilitation, Carver College of Medicine, University of Iowa, Iowa City, Iowa"},{"name":"Department of Orthopedics and Traumatology, Escola Paulista de Medicina, Universidade Federal de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5058-8867","authenticated-orcid":false,"given":"Matthieu","family":"Lalevee","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Rehabilitation, Carver College of Medicine, University of Iowa, Iowa City, Iowa"},{"name":"Service d\u2019orthop\u00e9die Traumatologie, Centre Hospitalier Universitaire de Rouen, Rouen, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3038-3391","authenticated-orcid":false,"given":"Alan","family":"Shamrock","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Rehabilitation, Carver College of Medicine, University of Iowa, Iowa City, Iowa"},{"name":"Hospital for Special Surgery, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0163-6516","authenticated-orcid":false,"given":"Francois","family":"Lintz","sequence":"additional","affiliation":[{"name":"Clinique de L\u2019Union, Saint-Jean-le-Blanc, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1082-6490","authenticated-orcid":false,"given":"Kepler Alencar Mendes","family":"de Carvalho","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Rehabilitation, Carver College of Medicine, University of Iowa, Iowa City, Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6037-0685","authenticated-orcid":false,"given":"Cesar","family":"de Cesar Netto","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Rehabilitation, Carver College of Medicine, University of Iowa, Iowa City, Iowa"},{"name":"Division of Foot and Ankle Surgery, Department of Orthopaedic Surgery, Duke University Health System, Duke University, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,10]]},"reference":[{"issue":"10","key":"R1-20240801","doi-asserted-by":"crossref","first-page":"1190","DOI":"10.1177\/1071100720936603","article-title":"Assessment of Posterior and Middle Facet Subluxation of the Subtalar Joint in Progressive Flatfoot Deformity","volume":"41","author":"de Cesar Netto","year":"2020","journal-title":"Foot Ankle Int"},{"issue":"8","key":"R2-20240801","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.2106\/00004623-199908000-00010","article-title":"Subluxation of the talocalcaneal joint in adults who have symptomatic flatfoot","volume":"81","author":"Ananthakrisnan","year":"1999","journal-title":"J Bone Joint Surg Am"},{"issue":"11","key":"R3-20240801","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.2106\/00004623-199911000-00006","article-title":"Complex reconstruction for the treatment of dorsolateral peritalar subluxation of the foot. 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