Progressive Collapsing Foot Deformity
A Modern Approach to Classification and Management
Progressive Collapsing Foot Deformity (PCFD) is the modern classification that replaces the traditional diagnoses of adult‑acquired flatfoot and posterior tibial tendon dysfunction. This updated framework recognises the condition as a multi‑segment, progressive deformity involving tendon insufficiency, ligament failure, and structural collapse across the hindfoot and midfoot. By shifting away from a tendon‑centric model, PCFD provides clearer diagnostic criteria, radiographic thresholds, and a more comprehensive understanding of deformity progression.
In addition to outlining the new PCFD classification, this presentation will examine patterns of midfoot collapse unrelated to Charcot neuroarthropathy, highlighting mechanical, ligamentous, and joint‑based failure modes that often go under‑recognised. A series of illustrative clinical cases will demonstrate how these deformities present in practice, how they differ from Charcot collapse, and how the updated classification improves assessment, staging, and pedorthic management.
Dr John Negrine
Dr John Negrine
Orthopaedic Surgeon ||
Prince of Wales Private Hospital
Dr. John Negrine graduated from the University of Sydney in 1984. He completed his residency at Royal North Shore Hospital Sydney.
In 1989 he was selected as Commonwealth Orthopaedic Registrar, Royal National Orthopaedic Hospital London.
In 1990 Dr Negrine commenced the Sydney Orthopaedic training scheme which he completed in 1993 gaining the Fellowship of the Royal Australasian College of Surgeons (Orthopaedic).
In 1994/5 he was the Accredited Foot and Ankle Fellow at Baylor University Medical Center, Dallas Texas where he studied and worked under the world renowned Foot Surgeon Dr. James W. Brodsky.
Dr. Negrine specialises exclusively in conditions of the Adult Foot and Ankle covering all aspects of sports injuries, arthritis and foot deformity.
Dr. Negrine is an Executive Member and past President (2008-2010 inclusive) of the Australian Orthopaedic Foot and Ankle Society, as well as a member of the Australian, American and European Foot and Ankle Societies. He also has numerous local and international presentations and publications to his name.
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