Which factors are associated with failure of conservative treatment in progressive collapsing foot deformity?

Authors

Lolita Micicoi, Wolfram Grün, Emily Luo, Anna Bryniarski, Enrico Pozzessere, Viren Umrethiya, Pierre-Henri Vermorel, François Lintz, Cesar de Cesar Netto

Published in

Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons. Sep 08, 2026. Epub Sep 08, 2026.

Abstract

Progressive collapsing foot deformity (PCFD) has a variable course, with over 10% of patients progressing to surgery despite nonoperative treatment.
Adults with PCFD initially treated nonoperatively and baseline weight-bearing CT were retrospectively stratified into nonoperative and surgical groups. Demographics, PROMIS, and WBCT alignment were compared.
Seventy-six feet were analyzed. Progression to surgery was associated with greater baseline hindfoot malalignment (Foot-Ankle Offset 9.0 ± 3.1 vs 6.6 ± 3.0, p = 0.046; Hindfoot Moment Arm p = 0.008), male sex (p = 0.008), and higher BMI (32.1 ± 7.3 vs 26.8 ± 5.2, p = 0.044). PROMIS and forefoot alignment did not discriminate outcomes.
In this exploratory cohort, a more valgus hindfoot alignment, male sex, and higher BMI emerged as potential predictors of failure of nonoperative treatment in PCFD, whereas baseline pain and physical function did not discriminate outcomes. These candidate factors warrant confirmation in larger, adequately powered studies before WBCT-derived alignment parameters can be used for risk stratification.
Level III - Retrospective comparative study.

PMID:
42728165
Bibliographic data and abstract were imported from PubMed on 12 Sep 2026.

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