{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T06:17:27Z","timestamp":1778221047485,"version":"3.51.4"},"reference-count":18,"publisher":"MJS Publishing, Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:00:00Z","timestamp":1778198400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ActaO"],"abstract":"<jats:p>Background and purpose:\u00a0Surgical 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\u201348 (minimal important difference 5). Secondary outcomes were EQ-5D and satisfaction.Results:\u00a0190 feet (63% women, median age 62 years, interquartile range 54\u201368) were surgically treated during the study period. Mean improvement in SEFAS score was 12 (95% confidence interval [CI] 10\u201313) in grade IIa and 10 (CI 8\u201312) in grade IIb, and in the EQ-5D index 0.27 (CI 0.20\u20130.34) and 0.23 (CI 0.15\u20130.31), 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\u201313) in the osteotomy group and 10 (CI 5\u201315) in the arthrodesis group; adjusted mean difference was 2.7 (CI \u20131.2 to 6.5).Conclusion:\u00a0Surgical 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.<\/jats:p>","DOI":"10.2340\/17453674.2026.45942","type":"journal-article","created":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T06:05:01Z","timestamp":1778220301000},"source":"Crossref","is-referenced-by-count":0,"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"],"prefix":"10.2340","volume":"97","author":[{"given":"Ida Karin Johanna","family":"Osbeck","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"C\u00f6ster","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isam","family":"Atroshi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1183","published-online":{"date-parts":[[2026,5,8]]},"reference":[{"key":"154667","doi-asserted-by":"crossref","unstructured":"Henry J K, Shakked R, Ellis S J. Adult-acquired flatfoot deformity. Foot Ankle Orthop 2019; 4(1): 2473011418820847. doi: 10.1177\/2473011418820847.","DOI":"10.1177\/2473011418820847"},{"key":"154668","doi-asserted-by":"crossref","unstructured":"Abousayed M M, Alley M C, Shakked R, Rosenbaum A J. Adult-acquired flatfoot deformity: etiology, diagnosis, and management. JBJS Rev 2017; 5(8): e7. doi: 10.2106\/JBJS.RVW.16.00116.","DOI":"10.2106\/JBJS.RVW.16.00116"},{"key":"154669","doi-asserted-by":"crossref","unstructured":"C\u00f6ster M C, Coster A, Svensson F, Callreus M, Montgomery F. Swefoot: the Swedish national quality register for foot and ankle surgery. Foot Ankle Surg 2022; 28(8): 1404-10. doi: 10.1016\/j.fas.2022.07.010.","DOI":"10.1016\/j.fas.2022.07.010"},{"key":"154670","doi-asserted-by":"crossref","unstructured":"C\u00f6ster M, Karlsson M K, Nilsson J A, Carlsson A. Validity, reliability, and responsiveness of a self-reported foot and ankle score (SEFAS). Acta Orthop 2012; 83(2): 197-203. doi: 10.3109\/17453674.2012.657579.","DOI":"10.3109\/17453674.2012.657579"},{"key":"154671","doi-asserted-by":"crossref","unstructured":"C\u00f6ster M C, Nilsdotter A, Brudin L, Bremander A. Minimally important change, measurement error, and responsiveness for the Self-Reported Foot and Ankle Score. Acta Orthop 2017; 88(3): 300-4. doi: 10.1080\/17453674.2017.1293445.","DOI":"10.1080\/17453674.2017.1293445"},{"key":"154672","doi-asserted-by":"crossref","unstructured":"C\u00f6ster M C, Rosengren B E, Karlsson M K, Carlsson A. Age- and gender-specific normative values for the Self-Reported Foot and Ankle Score (SEFAS). Foot Ankle Int 2018; 39(11): 1328-34. doi: 10.1177\/1071100718788499.","DOI":"10.1177\/1071100718788499"},{"key":"154673","doi-asserted-by":"crossref","unstructured":"C\u00f6ster M C, Bremander A, Rosengren B E, Magnusson H, Carlsson A, Karlsson M K. Validity, reliability, and responsiveness of the Self-reported Foot and Ankle Score (SEFAS) in forefoot, hindfoot, and ankle disorders. Acta Orthop 2014; 85(2): 187-94. doi: 10.3109\/17453674.2014.889979.","DOI":"10.3109\/17453674.2014.889979"},{"key":"154674","doi-asserted-by":"crossref","unstructured":"Christensen R, Ranstam J, Overgaard S, Wagner P. Guidelines for a structured manuscript: statistical methods and reporting in biomedical research journals. Acta Orthop 2023; 94: 243-9. doi: 10.2340\/17453674.2023.11656.","DOI":"10.2340\/17453674.2023.11656"},{"key":"154675","doi-asserted-by":"crossref","unstructured":"Jakobsen J C, Gluud C, Wetterslev J, Winkel P. When and how should multiple imputation be used for handling missing data in randomised clinical trials: a practical guide with flowcharts. 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