{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T09:44:23Z","timestamp":1793353463490,"version":"4.5.0"},"reference-count":17,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2019,1,18]],"date-time":"2019-01-18T00:00:00Z","timestamp":1547769600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Foot Ankle Int."],"published-print":{"date-parts":[[2019,5]]},"abstract":"\n Background:<\/jats:title>\n Residual supination of the midfoot during reconstruction of the stage II adult-acquired flatfoot deformity (AAFD) is often addressed with a medial cuneiform (Cotton) osteotomy after adequate correction of the hindfoot valgus deformity. The purpose of this study was to determine if there was a correlation between postoperative alignment of the medial cuneiform and patient-reported outcomes.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n Sixty-three feet in 61 patients with stage II AAFD who underwent a Cotton osteotomy as part of a flatfoot reconstruction were included in the study. Radiographic angles were measured on weightbearing lateral radiographs at a minimum of 40 weeks postoperatively. Pearson\u2019s correlation analysis was used to determine if there was an association between postoperative radiographic angles and Foot and Ankle Outcome Score (FAOS) at a minimum of 24 months postoperatively. Patients were also divided into mild plantarflexion (cuneiform articular angle [CAA] \u2265\u20132 degrees) and moderate plantarflexion (CAA <\u20132 degrees) groups to evaluate for differences in clinical outcomes.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Postoperative CAA was significantly positively correlated with the postoperative FAOS symptoms (\n r<\/jats:italic>\n = .27,\n P<\/jats:italic>\n = .03), daily activities (\n r<\/jats:italic>\n = .29,\n P<\/jats:italic>\n = .02), sports activities (\n r<\/jats:italic>\n = .26,\n P<\/jats:italic>\n = .048), and quality of life (\n r<\/jats:italic>\n = .28,\n P<\/jats:italic>\n = .02) subscales. Patients in the mild plantarflexion group had statistically and clinically better outcomes compared with the moderate plantarflexion group in the FAOS symptoms (\n P<\/jats:italic>\n = .04), daily activities (\n P<\/jats:italic>\n = .04), and sports activities (\n P<\/jats:italic>\n = .01) subscales.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n Our study suggests that the surgeon should avoid excessive plantarflexion of the medial cuneiform and use the Cotton osteotomy judiciously as part of a flatfoot reconstruction for stage II AAFD.<\/jats:p>\n <\/jats:sec>\n \n Level of Evidence:<\/jats:title>\n Level III, comparative series.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/1071100718822839","type":"journal-article","created":{"date-parts":[[2019,1,18]],"date-time":"2019-01-18T03:38:32Z","timestamp":1547782712000},"page":"491-498","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":35,"title":["Postoperative Medial Cuneiform Position Correlation With Patient-Reported Outcomes Following Cotton Osteotomy for Reconstruction of the Stage II Adult-Acquired Flatfoot Deformity"],"prefix":"10.1177","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3313-2520","authenticated-orcid":false,"given":"Matthew S.","family":"Conti","sequence":"first","affiliation":[{"name":"Hospital for Special Surgery, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5884-3009","authenticated-orcid":false,"given":"Jonathan H.","family":"Garfinkel","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace C.","family":"Kunas","sequence":"additional","affiliation":[{"name":"Georgetown University School of Medicine, Washington, DC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan T.","family":"Deland","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott J.","family":"Ellis","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,1,18]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/1071100715620894"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2012.0498"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/1071100715596607"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/1071100714564217"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/BTF.0000000000000164"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/1071100718777459"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM193602202140804"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.5435\/00124635-200807000-00005"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.blo.0000157658.17056.46"},{"key":"e_1_3_2_11_2","first-page":"95","volume-title":"Foot Ankle Int","volume":"32","author":"Haddad SL","year":"2011","unstructured":"Haddad SL, Myerson MS, Younger A, Anderson RB, Davis WH, Manoli AII. Symposium: adult acquired flatfoot deformity. Foot Ankle Int. 2011;32(1):95-111."},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/107110070402500810"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/1071100718768020"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2011.0278"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1177\/1071100713483117"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.fcl.2012.03.003"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2012.0940"},{"key":"e_1_3_2_18_2","volume-title":"Paper presented at the American Orthopaedic Foot & Ankle Society 2008 Annual Meeting","author":"Vander Griend R.","unstructured":"Vander Griend R.. Reconstruction of stage 2 posterior tibial tendon deficiency without surgical correction of residual forefoot varus. Paper presented at the American Orthopaedic Foot & Ankle Society 2008 Annual Meeting; June 25-28, 2008; Denver, CO."}],"container-title":["Foot & Ankle International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1071100718822839","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1071100718822839","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1071100718822839","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T21:23:18Z","timestamp":1777411398000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1071100718822839"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,1,18]]},"references-count":17,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2019,5]]}},"alternative-id":["10.1177\/1071100718822839"],"URL":"https:\/\/doi.org\/10.1177\/1071100718822839","relation":{},"ISSN":["1071-1007","1944-7876"],"issn-type":[{"value":"1071-1007","type":"print"},{"value":"1944-7876","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,1,18]]}}}