Early Weight Bearing Tarsometatarsal Fusion Study

NCT ID: NCT03812237

Last Updated: 2019-01-31

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

131 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-01-20

Study Completion Date

2017-12-01

Brief Summary

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A Prospective, Randomized, Controlled Trial Comparing Early Weight Bearing versus Non Weight Bearing Following Modified Lapidus Arthrodesis

Detailed Description

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The purpose of this prospective randomized control trial is to assess outcomes in patients who undergo modified Lapidus arthrodesis and whose postoperative management includes early weight bearing on heel (in a boot) and compare it to standard of care non weight bearing post operative management.

Conditions

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Hallux Valgus

Keywords

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Lapidus Arthrodesis Early Weight Bearing First Tarsometatarsal Arthrodesis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Prospective, Randomized, Controlled Trial
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Patients were blinded to treatment until their 2 week post-operative visit.

Study Groups

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(EWB) Early Weight Bearing (2 Weeks Post-op)

Subjects in the EWB group were allowed to begin bearing 50 pounds (lbs) through their hindfoot in either the boot or the short leg cast at the two-week visit. They were allowed to advance their weightbearing as tolerated by 25 lbs every four days until full weightbearing through the hindfoot was achieved.

Group Type EXPERIMENTAL

(EWB) Early Weight Bearing (2 Weeks Post-op)

Intervention Type OTHER

Patient were permitted to progressively weightbear on their heel at 2 week post-op.

(SOC) Standard of Care Weight Bearing (6-8 Weeks Post-op)

Subjects in the SOC group were allowed to heel touch weightbear for balance only on the operative foot until the six to eight week visit. At this visit all subjects were placed into a short leg walking boot. Non-weightbearing patients were permitted to begin the progressive weightbearing protocol, without hindfoot restriction.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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(EWB) Early Weight Bearing (2 Weeks Post-op)

Patient were permitted to progressively weightbear on their heel at 2 week post-op.

Intervention Type OTHER

Other Intervention Names

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EWB

Eligibility Criteria

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Inclusion Criteria

* Patient has signed the Institutional Review Board approved informed consent form specific to this study prior to enrollment
* Failure of conservative treatment (i.e. non-surgical action, consisting of footwear modification in the form of shoes with wide toe boxes, padded inserts, activity modifications and pain control medications)
* Patients who underwent Lapidus procedure with or without other procedures of the first ray (i.e., muscle-tendon procedures, distal metatarsal osteotomy, Akin procedure)
* Patient older than 18 years of age
* Patient is able to give informed consent
* Patient is independent, ambulatory, and agrees to comply with all postoperative visits

Exclusion Criteria

* Patient has a pre-existing condition which may cause impairment of healing and bone fusion
* Any significant pathology that, in the opinion of investigator, makes the patient unsuitable for study
* Patients who underwent Lapidus arthrodesis in conjunction with other procedures that did not focus on the first pedal ray with the exception of harvesting autogenous ipsilateral calcaneal bone graft
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Grand Rapids Medical Education Partners

OTHER

Sponsor Role collaborator

Orthopaedic Associates of Michigan, PC

OTHER

Sponsor Role lead

Responsible Party

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John G. Anderson, MD

Orthopaedic Surgeon - Foot and Ankle

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Orthopaedic Associates of Michigan, PC

Grand Rapids, Michigan, United States

Site Status

Countries

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United States

References

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Bednarz PA, Manoli A 2nd. Modified lapidus procedure for the treatment of hypermobile hallux valgus. Foot Ankle Int. 2000 Oct;21(10):816-21. doi: 10.1177/107110070002101004.

Reference Type BACKGROUND
PMID: 11128011 (View on PubMed)

Clark HR, Veith RG, Hansen ST Jr. Adolescent bunions treated by the modified Lapidus procedure. Bull Hosp Jt Dis Orthop Inst. 1987 Fall;47(2):109-22.

Reference Type BACKGROUND
PMID: 2825872 (View on PubMed)

Saxena A, Nguyen A, Nelsen E. Lapidus bunionectomy: Early evaluation of crossed lag screws versus locking plate with plantar lag screw. J Foot Ankle Surg. 2009 Mar-Apr;48(2):170-9. doi: 10.1053/j.jfas.2008.12.009.

Reference Type BACKGROUND
PMID: 19232969 (View on PubMed)

Rutherford RL. The Lapidus procedure for primus metatarsus adductus. J Am Podiatry Assoc. 1974 Aug;64(8):581-4. doi: 10.7547/87507315-64-8-581. No abstract available.

Reference Type BACKGROUND
PMID: 4845803 (View on PubMed)

McInnes BD, Bouche RT. Critical evaluation of the modified Lapidus procedure. J Foot Ankle Surg. 2001 Mar-Apr;40(2):71-90. doi: 10.1016/s1067-2516(01)80048-x.

Reference Type BACKGROUND
PMID: 11324674 (View on PubMed)

Bacardi BE, Boysen TJ. Considerations for the Lapidus operation. J Foot Surg. 1986 Mar-Apr;25(2):133-8.

Reference Type BACKGROUND
PMID: 3711593 (View on PubMed)

Christenson C, Jones RO, Basque M, Mollohan E. Comparison of oblique closing base wedge osteotomies of the first metatarsal: stripping versus nonstripping of the periosteum. J Foot Surg. 1991 Mar-Apr;30(2):107-13.

Reference Type BACKGROUND
PMID: 1865058 (View on PubMed)

Hansen ST Jr. Hallux valgus surgery. Morton and Lapidus were right! Clin Podiatr Med Surg. 1996 Jul;13(3):347-54.

Reference Type BACKGROUND
PMID: 8829031 (View on PubMed)

Mendicino R, Catanzariti AR, Hofbauer M, Saltrick KR. The modified lapidus arthrodesis: technical maneuvers and pearls. J Foot Ankle Surg. 2000 Jul-Aug;39(4):258-64. doi: 10.1016/s1067-2516(00)80010-1. No abstract available.

Reference Type BACKGROUND
PMID: 10949807 (View on PubMed)

LAPIDUS PW. The author's bunion operation from 1931 to 1959. Clin Orthop. 1960;16:119-35. No abstract available.

Reference Type RESULT
PMID: 14414101 (View on PubMed)

Sangeorzan BJ, Hansen ST Jr. Modified Lapidus procedure for hallux valgus. Foot Ankle. 1989 Jun;9(6):262-6. doi: 10.1177/107110078900900602.

Reference Type RESULT
PMID: 2744666 (View on PubMed)

Myerson M, Allon S, McGarvey W. Metatarsocuneiform arthrodesis for management of hallux valgus and metatarsus primus varus. Foot Ankle. 1992 Mar-Apr;13(3):107-15. doi: 10.1177/107110079201300301.

Reference Type RESULT
PMID: 1601337 (View on PubMed)

Hernandez A, Hernandez PA, Hernandez WA. Lapidus: when and why? Clin Podiatr Med Surg. 1989 Jan;6(1):197-208.

Reference Type RESULT
PMID: 2653609 (View on PubMed)

Catanzariti AR, Mendicino RW, Lee MS, Gallina MR. The modified Lapidus arthrodesis: a retrospective analysis. J Foot Ankle Surg. 1999 Sep-Oct;38(5):322-32. doi: 10.1016/s1067-2516(99)80003-9.

Reference Type RESULT
PMID: 10553545 (View on PubMed)

Myerson MS, Badekas A. Hypermobility of the first ray. Foot Ankle Clin. 2000 Sep;5(3):469-84.

Reference Type RESULT
PMID: 11232392 (View on PubMed)

Ray RG. First metatarsocuneiform arthrodesis: technical considerations and technique modification. J Foot Ankle Surg. 2002 Jul-Aug;41(4):260-72. doi: 10.1016/s1067-2516(02)80025-4.

Reference Type RESULT
PMID: 12194518 (View on PubMed)

Kopp FJ, Patel MM, Levine DS, Deland JT. The modified Lapidus procedure for hallux valgus: a clinical and radiographic analysis. Foot Ankle Int. 2005 Nov;26(11):913-7. doi: 10.1177/107110070502601103.

Reference Type RESULT
PMID: 16309603 (View on PubMed)

Coetzee JC, Resig SG, Kuskowski M, Saleh KJ. The Lapidus procedure as salvage after failed surgical treatment of hallux valgus. Surgical technique. J Bone Joint Surg Am. 2004 Mar;86-A Suppl 1:30-6. doi: 10.2106/00004623-200403001-00005.

Reference Type RESULT
PMID: 14996919 (View on PubMed)

Saffo G, Wooster MF, Stevens M, Desnoyers R, Catanzariti AR. First metatarsocuneiform joint arthrodesis: a five-year retrospective analysis. J Foot Surg. 1989 Sep-Oct;28(5):459-65.

Reference Type RESULT
PMID: 2584630 (View on PubMed)

Gutteck N, Wohlrab D, Zeh A, Radetzki F, Delank KS, Lebek S. Immediate fullweightbearing after tarsometatarsal arthrodesis for hallux valgus correction--Does it increase the complication rate? Foot Ankle Surg. 2015 Sep;21(3):198-201. doi: 10.1016/j.fas.2014.11.010. Epub 2014 Dec 29.

Reference Type RESULT
PMID: 26235860 (View on PubMed)

Goldstein CL, Schemitsch E, Bhandari M, Mathew G, Petrisor BA. Comparison of different outcome instruments following foot and ankle trauma. Foot Ankle Int. 2010 Dec;31(12):1075-80. doi: 10.3113/FAI.2010.1075.

Reference Type RESULT
PMID: 21189208 (View on PubMed)

Prissel MA, Hyer CF, Grambart ST, Bussewitz BW, Brigido SA, DiDomenico LA, Lee MS, Reeves CL, Shane AM, Tucker DJ, Weinraub GM. A Multicenter, Retrospective Study of Early Weightbearing for Modified Lapidus Arthrodesis. J Foot Ankle Surg. 2016 Mar-Apr;55(2):226-9. doi: 10.1053/j.jfas.2015.09.003. Epub 2016 Jan 5.

Reference Type RESULT
PMID: 26763868 (View on PubMed)

King CM, Richey J, Patel S, Collman DR. Modified lapidus arthrodesis with crossed screw fixation: early weightbearing in 136 patients. J Foot Ankle Surg. 2015 Jan-Feb;54(1):69-75. doi: 10.1053/j.jfas.2014.09.034. Epub 2014 Oct 31.

Reference Type RESULT
PMID: 25451208 (View on PubMed)

Other Identifiers

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OAM-TMT-01

Identifier Type: -

Identifier Source: org_study_id