Trial Outcomes & Findings for Duration of Brace Wear in Clubfoot Treatment - A Prospective Randomized Trial (NCT NCT01551264)

NCT ID: NCT01551264

Last Updated: 2021-11-30

Results Overview

Kaplan-Meier recurrence-free survival probability for each limb affected by clubfoot up to 1 year after bracing is discontinued. For patients with bilateral clubfoot, each limb was assessed. Bilateral patients contribute data for both limbs and unilateral patients contribute data for the affected limb. Recurrence is defined as the development of any of the following deformities in isolation or in combination that require repeat cast application or surgical intervention: hindfoot varus, ankle equinus, midfoot adduction, midfoot cavus, or forefoot pronation. Clubfoot recurrence was determined by the local Principal Investigator.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

139 participants

Primary outcome timeframe

From end of bracing treatment until the earliest recurrence up to 1 year (allowing for per-protocol visit window of 1.2 years) after the assigned treatment (2- or 4-year bracing) is discontinued.

Results posted on

2021-11-30

Participant Flow

Participant milestones

Participant milestones
Measure
4-Year Bracing Arm
This group has been randomized to 4 years of bracing after correction of clubfoot using the Ponseti Method. Foot Abduction Brace (FAB): After clubfoot correction, the participants will wear the FAB 23 hours/day for 3 months and then wean to naps and nighttime (8-12 hours/day) for 4 years.
2-Year Bracing Arm
This group has been randomized to 2 years of bracing after correction of clubfoot using the Ponseti Method. Foot Abduction Brace (FAB): After clubfoot correction, the participants will wear the FAB 23 hours/day for 3 months and then wean to naps and nighttime (8-12 hours/day) for 2 years.
Overall Study
STARTED
70
69
Overall Study
Started Bracing
69
67
Overall Study
Data for at Least One Follow-up After Brace Discontinuation Ascertained
44
55
Overall Study
COMPLETED
38
41
Overall Study
NOT COMPLETED
32
28

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Duration of Brace Wear in Clubfoot Treatment - A Prospective Randomized Trial

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
4-Year Bracing Arm
n=70 Participants
This group has been randomized to 4 years of bracing after correction of clubfoot using the Ponseti Method. Foot Abduction Brace (FAB): After clubfoot correction, the participants will wear the FAB 23 hours/day for 3 months and then wean to naps and nighttime (8-12 hours/day) for 4 years.
2-Year Bracing Arm
n=69 Participants
This group has been randomized to 2 years of bracing after correction of clubfoot using the Ponseti Method. Foot Abduction Brace (FAB): After clubfoot correction, the participants will wear the FAB 23 hours/day for 3 months and then wean to naps and nighttime (8-12 hours/day) for 2 years.
Total
n=139 Participants
Total of all reporting groups
Age, Categorical
<=18 years
70 Participants
n=5 Participants
69 Participants
n=7 Participants
139 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Age, Categorical
>=65 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Age, Continuous
1.8 Months
STANDARD_DEVIATION 1.7 • n=5 Participants
1.8 Months
STANDARD_DEVIATION 1.5 • n=7 Participants
1.8 Months
STANDARD_DEVIATION 1.6 • n=5 Participants
Sex: Female, Male
Female
18 Participants
n=5 Participants
23 Participants
n=7 Participants
41 Participants
n=5 Participants
Sex: Female, Male
Male
52 Participants
n=5 Participants
46 Participants
n=7 Participants
98 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
4 Participants
n=5 Participants
1 Participants
n=7 Participants
5 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
1 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
4 Participants
n=5 Participants
4 Participants
n=7 Participants
8 Participants
n=5 Participants
Race (NIH/OMB)
White
57 Participants
n=5 Participants
59 Participants
n=7 Participants
116 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
3 Participants
n=5 Participants
4 Participants
n=7 Participants
7 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
1 Participants
n=5 Participants
1 Participants
n=7 Participants
2 Participants
n=5 Participants
Region of Enrollment
United States
70 participants
n=5 Participants
69 participants
n=7 Participants
139 participants
n=5 Participants
Measure Description: Laterality of isolated clubfoot at enrollment
Unilateral
35 Participants
n=5 Participants
35 Participants
n=7 Participants
70 Participants
n=5 Participants
Measure Description: Laterality of isolated clubfoot at enrollment
Bilateral
35 Participants
n=5 Participants
34 Participants
n=7 Participants
69 Participants
n=5 Participants
Family history of clubfoot in first-degree relative
Presence
9 Participants
n=5 Participants
10 Participants
n=7 Participants
19 Participants
n=5 Participants
Family history of clubfoot in first-degree relative
Absence
61 Participants
n=5 Participants
59 Participants
n=7 Participants
120 Participants
n=5 Participants

PRIMARY outcome

Timeframe: From end of bracing treatment until the earliest recurrence up to 1 year (allowing for per-protocol visit window of 1.2 years) after the assigned treatment (2- or 4-year bracing) is discontinued.

Population: For patients with bilateral clubfoot, each limb was assessed. Bilateral patients contribute data for both limbs and unilateral patients contribute data for the affected limb. Analysis includes limbs from participants who started bracing and attended at least one visit within one year after discontinuing bracing.

Kaplan-Meier recurrence-free survival probability for each limb affected by clubfoot up to 1 year after bracing is discontinued. For patients with bilateral clubfoot, each limb was assessed. Bilateral patients contribute data for both limbs and unilateral patients contribute data for the affected limb. Recurrence is defined as the development of any of the following deformities in isolation or in combination that require repeat cast application or surgical intervention: hindfoot varus, ankle equinus, midfoot adduction, midfoot cavus, or forefoot pronation. Clubfoot recurrence was determined by the local Principal Investigator.

Outcome measures

Outcome measures
Measure
4-Year Bracing Arm
n=65 limb
This group has been randomized to 4 years of bracing after correction of clubfoot using the Ponseti Method. Foot Abduction Brace (FAB): After clubfoot correction, the participants will wear the FAB 23 hours/day for 3 months and then wean to naps and nighttime (8-12 hours/day) for either 2 or 4 years depending on which arm they are in.
2-Year Bracing Arm
n=82 limb
This group has been randomized to 2 years of bracing after correction of clubfoot using the Ponseti Method. Foot Abduction Brace (FAB): After clubfoot correction, the participants will wear the FAB 23 hours/day for 3 months and then wean to naps and nighttime (8-12 hours/day) for either 2 or 4 years depending on which arm they are in.
Kaplan-Meier Recurrence-Free Survival Probability for Clubfoot Affected Limbs
0.81 survival probability
Interval 0.7 to 0.95
0.65 survival probability
Interval 0.52 to 0.8

Adverse Events

4-Year Bracing Arm

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

2-Year Bracing Arm

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Matthew Dobbs MD

Washington University School of Medicine

Phone: 561-844-5255

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place