Swedish study shows flatfoot surgery improves patient outcomes within one year
A study of 190 flatfoot surgery patients in Sweden found significant improvements in foot function and satisfaction one year after treatment, with 77% of patients satisfied with their foot appearance post-surgery compared to 39% before. The findings provide rare real-world evidence on surgical effectiveness, offering clinicians and healthcare systems concrete data for treatment planning and resource allocation.
Originaltitel: 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
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.