title: Surgery for adult acquired flatfoot due to posterior tibial tendon dysfunction reduces pain, improves function and health related quality of life.
abstract: BACKGROUND
  Patients with adult acquired flatfoot deformity (AAFD) due to posterior tibial tendon dysfunction (PTTD) may require surgery but few reports have evaluated the outcome.
  
  
  METHODS
  We evaluated 21 patients with a median age of 60 (range 37-72) years who underwent different surgical reconstructions due to stage II AAFD before and 6 and 24 months after surgery by the validated Self-Reported Foot and Ankle Score (SEFAS), Short Form 36 (SF-36) and Euroquol 5 Dimensions (EQ-5D).
  
  
  RESULTS
  The improvement from before to 24 months after surgery was in SEFAS mean 12 (95% confidence interval 8-15), SF-36 physical function 21 (10-22), SF-36 bodily pain 28 (17-38), EQ-5D 0.2 (0.1-0.3) and EQ-VAS 11 (2-21).
  
  
  CONCLUSIONS
  Surgery for AFFD due to PTTD results in reduced pain and improved function and health related quality of life. The outcome scores have been demonstrated as useful. It has also been shown, since there is a further improvement between 6 and 24 months after surgery, that a minimum follow-up of 2 years is needed.
  
  
  METHODS
  III - prospective observational cohort study.
authors.affiliation: Departments of Orthopedics and Clinical Sciences, Lund University, Skåne University Hospital Malmö, Sweden. Electronic address: maria.coster@med.lu.se.
authors.forename: M C
authors.initials: MC
authors.lastname: Cöster
authors.affiliation: Departments of Orthopedics and Clinical Sciences, Lund University, Skåne University Hospital Malmö, Sweden.
authors.forename: B E
authors.initials: BE
authors.lastname: Rosengren
authors.affiliation: Departments of Rheumatology and Clinical Sciences Lund, Lund University, Lund, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Bremander
authors.affiliation: Departments of Orthopedics and Clinical Sciences, Lund University, Skåne University Hospital Malmö, Sweden.
authors.forename: M K
authors.initials: MK
authors.lastname: Karlsson
mesh_terms: D000328:Adult; D000368:Aged; D002111:Calcaneus / Q000601:surgery; D005260:Female; D005413:Flatfoot / Q000150:complications / Q000601:surgery*; D006801:Humans; D008023:Ligaments, Articular / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010027:Osteotomy; D010146:Pain / Q000209:etiology / Q000601:surgery; D063868:Patient Outcome Assessment; D037081:Posterior Tibial Tendon Dysfunction / Q000150:complications / Q000601:surgery*; D011446:Prospective Studies; D011788:Quality of Life; D020127:Recovery of Function; D013709:Tendon Transfer
keywords: Adult acquired flatfoot deformity; Function; Outcome; Pain; Patient-reported outcome; Posterior tibial tendon dysfunction; SEFAS; Self-Reported Foot and Ankle Score; Surgery