1-year results after surgery for flexible adult-acquired flatfoot deformity : a cohort study based on 190 patients from the Swedish Foot and Ankle Surgery Register
(2026) In Acta Orthopaedica 97. p.279-285- Abstract
BACKGROUND AND PURPOSE: Surgical outcomes in patients with flexible adult-acquired flatfoot deformity (AAFD) have not been evaluated in large prospective register studies. Calcaneal osteotomy and hindfoot arthrodesis are commonly used. We aimed to compare the results of these 2 procedures using preoperative and 1-year postoperative patient-reported outcome data from the Swedish Quality Register for Foot and Ankle Surgery (Swefoot).
METHODS: We analyzed data regarding feet that had primary surgery for flexible (grade II) AAFD between 2017 and 2022 in Sweden. The primary outcome was the Self-Reported Foot and Ankle Score (SEFAS), range 0-48 (minimal important difference 5). Secondary outcomes were EQ-5D and... (More)
BACKGROUND AND PURPOSE: Surgical outcomes in patients with flexible adult-acquired flatfoot deformity (AAFD) have not been evaluated in large prospective register studies. Calcaneal osteotomy and hindfoot arthrodesis are commonly used. We aimed to compare the results of these 2 procedures using preoperative and 1-year postoperative patient-reported outcome data from the Swedish Quality Register for Foot and Ankle Surgery (Swefoot).
METHODS: We analyzed data regarding feet that had primary surgery for flexible (grade II) AAFD between 2017 and 2022 in Sweden. The primary outcome was the Self-Reported Foot and Ankle Score (SEFAS), range 0-48 (minimal important difference 5). Secondary outcomes were EQ-5D and satisfaction.
RESULTS: 190 feet (63% women, median age 62 years, interquartile range 54-68) were surgically treated during the study period. Mean improvement in SEFAS score was 12 (95% confidence interval [CI] 10-13) in grade IIa and 10 (CI 8-12) in grade IIb, and in the EQ-5D index 0.27 (CI 0.20-0.34) and 0.23 (CI 0.15-0.31), respectively. Compared with preoperatively a higher percentage of patients were satisfied with postoperative foot appearance (77% vs 39%) and foot strength (66% vs 23%). The mean SEFAS score improvement was 11 (CI 10-13) in the osteotomy group and 10 (CI 5-15) in the arthrodesis group; adjusted mean difference was 2.7 (CI -1.2 to 6.5).
CONCLUSION: Surgical treatment of flexible AAFD significantly improves function and quality of life at 1 year postoperatively. No differences in postoperative patient-reported outcomes were observed between patients who underwent calcaneal osteotomy compared with hindfoot arthrodesis.
(Less)
- author
- Osbeck, Ida Karin Johanna LU ; Cöster, Maria LU and Atroshi, Isam LU
- organization
- publishing date
- 2026-05-08
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Humans, Flatfoot/surgery, Female, Male, Middle Aged, Aged, Sweden, Arthrodesis/methods, Registries, Osteotomy/methods, Patient Reported Outcome Measures, Patient Satisfaction, Calcaneus/surgery, Treatment Outcome, Foot Deformities, Acquired/surgery, Cohort Studies
- in
- Acta Orthopaedica
- volume
- 97
- pages
- 279 - 285
- publisher
- Taylor & Francis
- external identifiers
-
- pmid:42099081
- scopus:105038093723
- ISSN
- 1745-3682
- DOI
- 10.2340/17453674.2026.45942
- language
- English
- LU publication?
- yes
- id
- e7d100db-f308-4954-a4db-27c45ba04c55
- date added to LUP
- 2026-05-08 13:09:58
- date last changed
- 2026-08-26 18:03:00
@article{e7d100db-f308-4954-a4db-27c45ba04c55,
abstract = {{<p>BACKGROUND AND PURPOSE: Surgical outcomes in patients with flexible adult-acquired flatfoot deformity (AAFD) have not been evaluated in large prospective register studies. Calcaneal osteotomy and hindfoot arthrodesis are commonly used. We aimed to compare the results of these 2 procedures using preoperative and 1-year postoperative patient-reported outcome data from the Swedish Quality Register for Foot and Ankle Surgery (Swefoot).</p><p>METHODS: We analyzed data regarding feet that had primary surgery for flexible (grade II) AAFD between 2017 and 2022 in Sweden. The primary outcome was the Self-Reported Foot and Ankle Score (SEFAS), range 0-48 (minimal important difference 5). Secondary outcomes were EQ-5D and satisfaction.</p><p>RESULTS: 190 feet (63% women, median age 62 years, interquartile range 54-68) were surgically treated during the study period. Mean improvement in SEFAS score was 12 (95% confidence interval [CI] 10-13) in grade IIa and 10 (CI 8-12) in grade IIb, and in the EQ-5D index 0.27 (CI 0.20-0.34) and 0.23 (CI 0.15-0.31), respectively. Compared with preoperatively a higher percentage of patients were satisfied with postoperative foot appearance (77% vs 39%) and foot strength (66% vs 23%). The mean SEFAS score improvement was 11 (CI 10-13) in the osteotomy group and 10 (CI 5-15) in the arthrodesis group; adjusted mean difference was 2.7 (CI -1.2 to 6.5).</p><p>CONCLUSION: Surgical treatment of flexible AAFD significantly improves function and quality of life at 1 year postoperatively. No differences in postoperative patient-reported outcomes were observed between patients who underwent calcaneal osteotomy compared with hindfoot arthrodesis.</p>}},
author = {{Osbeck, Ida Karin Johanna and Cöster, Maria and Atroshi, Isam}},
issn = {{1745-3682}},
keywords = {{Humans; Flatfoot/surgery; Female; Male; Middle Aged; Aged; Sweden; Arthrodesis/methods; Registries; Osteotomy/methods; Patient Reported Outcome Measures; Patient Satisfaction; Calcaneus/surgery; Treatment Outcome; Foot Deformities, Acquired/surgery; Cohort Studies}},
language = {{eng}},
month = {{05}},
pages = {{279--285}},
publisher = {{Taylor & Francis}},
series = {{Acta Orthopaedica}},
title = {{1-year results after surgery for flexible adult-acquired flatfoot deformity : a cohort study based on 190 patients from the Swedish Foot and Ankle Surgery Register}},
url = {{http://dx.doi.org/10.2340/17453674.2026.45942}},
doi = {{10.2340/17453674.2026.45942}},
volume = {{97}},
year = {{2026}},
}