Postoperative Medial Cuneiform Position Correlation With Patient-Reported Outcomes Following Cotton Osteotomy for Reconstruction of the Stage II Adult-Acquired Flatfoot Deformity

• Published in: Foot & ankle international 2019-05, Vol.40 (5), p.491-498
• Main Authors: Conti, Matthew S., Garfinkel, Jonathan H., Kunas, Grace C., Deland, Jonathan T., Ellis, Scott J.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Female; Flatfoot - diagnostic imaging; Flatfoot - surgery; Foot Deformities, Acquired - diagnostic imaging; Foot Deformities, Acquired - surgery; Humans; Male; Middle Aged; Osteotomy; Patient Reported Outcome Measures; Radiography; Tarsal Bones - diagnostic imaging; Tarsal Bones - physiopathology; Tarsal Bones - surgery; Young Adult
• ISSN: 1071-1007; 1944-7876
• DOI: 10.1177/1071100718822839

Background: 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. Methods: 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’s 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] ≥–2 degrees) and moderate plantarflexion (CAA