{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T09:44:24Z","timestamp":1793353464867,"version":"4.5.0"},"reference-count":14,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2021,6,10]],"date-time":"2021-06-10T00:00:00Z","timestamp":1623283200000},"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":[[2021,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>We investigated the long-term radiographic outcomes of the Cotton osteotomy performed at our institution by the 2 senior authors in conjunction with other reconstruction procedures to correct adult-acquired flatfoot deformity (AAFD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We retrospectively studied patients who underwent Cotton osteotomy between 2005 and 2010 with minimum 4-year follow-up. Radiographic assessment was made on weightbearing radiographs taken at 4 different time intervals: preoperative, early (first postoperative full weightbearing), intermediate (between 1 and 4 years postoperatively), and final (over 4 years postoperatively).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Nineteen patients were included. Final follow-up was 8.6 \u00b1 2.6 years. The lateral talus\u2013first metatarsal angle improved significantly from preoperative to early radiographs (n = 15; mean change: 30 degrees, 95% CI, 21.6-38.7; P &lt; .0001). A significant loss of correction was observed between intermediate and final radiographs (n = 11; mean change: 17 degrees, 95% CI, 8.1-26.4; P &lt; .0001). Of 14 patients with early radiographs, 8 lost &gt;50% of the correction initially achieved. Medial column height decreased by 3.0 mm (95% CI, 1.80-7.90; P = .35) between early radiographs and final follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>This is the longest reported radiographic follow-up of the Cotton osteotomy performed to address forefoot varus deformity as part of AAFD. The Cotton osteotomy achieved radiographic correction of the medial longitudinal arch at early follow-up, but approximately half of the patients had lost over 50% of that correction at final follow-up. The lengthened angular shape of the cuneiform did not collapse, implying that further collapse occurred through the medial column joints.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>Level IV, case series.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10711007211015175","type":"journal-article","created":{"date-parts":[[2021,6,10]],"date-time":"2021-06-10T06:43:01Z","timestamp":1623307381000},"page":"1384-1390","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":11,"title":["Radiographic Outcomes of Cotton Osteotomy in Treatment of Adult-Acquired Flatfoot Deformity"],"prefix":"10.1177","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8412-4275","authenticated-orcid":false,"given":"Mostafa M.","family":"Abousayed","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3982-9951","authenticated-orcid":false,"given":"Michelle M.","family":"Coleman","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6037-0685","authenticated-orcid":false,"given":"Cesar","family":"de Cesar Netto","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9778-3598","authenticated-orcid":false,"given":"Lew C.","family":"Schon","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1238-3673","authenticated-orcid":false,"given":"Gregory P.","family":"Guyton","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,6,10]]},"reference":[{"key":"bibr1-10711007211015175","doi-asserted-by":"publisher","DOI":"10.1177\/1071100715620894"},{"key":"bibr2-10711007211015175","doi-asserted-by":"publisher","DOI":"10.1177\/1071100713517098"},{"key":"bibr3-10711007211015175","doi-asserted-by":"publisher","DOI":"10.1016\/j.fcl.2007.03.003"},{"key":"bibr4-10711007211015175","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2012.0498"},{"key":"bibr5-10711007211015175","doi-asserted-by":"publisher","DOI":"10.1177\/1071100718822839"},{"key":"bibr6-10711007211015175","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM193602202140804"},{"key":"bibr7-10711007211015175","doi-asserted-by":"publisher","DOI":"10.5435\/00124635-200807000-00005"},{"key":"bibr8-10711007211015175","doi-asserted-by":"publisher","DOI":"10.1097\/01.blo.0000157658.17056.46"},{"key":"bibr9-10711007211015175","doi-asserted-by":"publisher","DOI":"10.1177\/107110070402500810"},{"key":"bibr10-10711007211015175","doi-asserted-by":"publisher","DOI":"10.1177\/1071100713518505"},{"key":"bibr11-10711007211015175","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2011.0278"},{"key":"bibr12-10711007211015175","doi-asserted-by":"publisher","DOI":"10.1016\/j.fcl.2012.03.003"},{"key":"bibr13-10711007211015175","first-page":"393","volume":"46","author":"Myerson MS.","year":"1997","journal-title":"Instr Course Lect"},{"key":"bibr14-10711007211015175","doi-asserted-by":"publisher","DOI":"10.1155\/2019\/1472471"}],"container-title":["Foot &amp; 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