Optimal Sequence of Corrective Surgeries for Concomitant Valgus Knee and Rigid Pes Planus Deformities: The Knee-First Approach

Adam Pasquinelly; Dalton Blood; Osama Elattar; Maged Hanna

doi:10.1016/j.artd.2023.101265

Optimal Sequence of Corrective Surgeries for Concomitant Valgus Knee and Rigid Pes Planus Deformities: The Knee-First Approach

Arthroplast Today. 2023 Nov 4:24:101265. doi: 10.1016/j.artd.2023.101265. eCollection 2023 Dec.

Authors

Adam Pasquinelly¹, Dalton Blood², Osama Elattar², Maged Hanna²

Affiliations

¹ University of Toledo College of Medicine and Life Sciences, Toledo, OH.
² Department of Orthopedic Surgery, University of Toledo College of Medicine and Life Sciences, Toledo, OH.

Abstract

In patients requiring surgical correction of ipsilateral valgus knee and rigid pes planovalgus deformities, the optimal operative sequence is controversial. Growing evidence suggests these 2 deformities are related in etiology and interrelated in disease course. We present the case of a 72-year-old female with concomitant valgus knee and rigid pes planovalgus deformities successfully treated with total knee arthroplasty followed by triple arthrodesis and Achilles lengthening. Surgical correction of these deformities must be carefully planned between the operating surgeons to avoid over- or under-correction of alignment that could further impact gait. In contrast with the limited available literature, the authors recommend correction at the knee first and the foot and ankle second. Further prospective studies are needed to elucidate the best operative sequence in these patients.

Keywords: pes planovalgus; total knee arthroplasty; triple arthrodesis; valgus knee.

Publication types

Case Reports