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September 10, 2026Foot & Ankle International

Three-Dimensional Osseous Alignment and Morphology Patterns of Ankle and Hindfoot Osteoarthritis

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Authors

ELE Renae LapinsAPAndrew C. PetersonMMMegan K. Mills

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Overview

Retrospective cross-sectional study reveals distinct 3D alignment patterns across ankle and hindfoot osteoarthritis subtypes, indicating that global foot shape influences joint-specific wear.

Key Points

  • To determine whether isolated subtalar, isolated tibiotalar, and combined ankle-hindfoot osteoarthritis present distinct three-dimensional osseous alignment and morphology profiles corresponding to specific foot types.
  • Analyzed weightbearing computed tomography (WBCT) scans from 196 participants (retrospective cohort), including 130 patients with osteoarthritis (subtalar, tibiotalar, or combined) and 66 non-osteoarthritic controls categorized as planus, rectus, or cavus.
  • Applied a 14-bone statistical shape model evaluated via principal components analysis, Hotelling's T² tests, automated radiographic measurements, and joint space mapping.
  • Principal component mode 1 defined a cavus-to-planus alignment gradient, whereas mode 3 tracked joint space narrowing.
  • Tibiotalar osteoarthritis strongly aligned with a cavus foot morphology displaying increased hindfoot varus, subtalar osteoarthritis corresponded closely to a neutral rectus foot type, and combined disease demonstrated the widest variation across both varus and valgus alignments.
  • The non-osteoarthritic planus group showed statistically significant morphological divergence from all osteoarthritis cohorts across all comparative analyses.

Cite This Study

Lapins et al. (2026) studied this question.

synapsesocial.com/papers/6aa27ba958559d80afc74fbchttps://doi.org/10.1177/10711007261472907
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