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Non-drug, non-surgical strategies are recommended as first line treatments in international OA clinical guidelines, however there have only ever been two randomised controlled trials (RCTs) of these treatments for first MTP joint OA, and one randomized clinical feasibility study. The condition causes dorsal osteophytes and joint space narrowing which impair range of motion, and in turn, lead to substantial problems performing functional weight bearing activities and impaired quality of life. First MTP joint OA is highly debilitating with most (72%) of those affected reporting the symptoms as disabling. Osteoarthritis (OA) of the foot affects 16.7% of people aged 50 years and older, making it as prevalent as knee OA, and the most commonly affected foot site is the first metatarsophalangeal (MTP) joint. Prospectively registered with the Australian New Zealand Clinical Trials Registry (reference: ACTRN12619000926134) on. Outcomes will help to inform clinical guidelines and practice about the use of foot orthoses for managing symptoms in this under-researched group of people with OA. This study will provide novel evidence about whether contoured foot orthoses improve pain and other symptoms compared to sham insoles in people with first MTP joint OA. Secondary outcomes include additional measures of first MTP joint and foot pain, physical function, quality of life, participant-perceived global ratings of change (pain and function), and level of physical activity. The primary outcome is self-reported first MTP joint pain on walking (numerical rating scale), assessed at baseline and 12 weeks. Participants have two visits with a study podiatrist where they are provided with their allocated insoles, to be worn daily for 12 weeks at all times when wearing shoes. Following baseline assessment, participants are randomized to receive either: i) contoured foot orthoses or ii) sham flat insoles following baseline assessment. We are recruiting 88 community-dwelling people with symptomatic radiographic first MTP joint OA.
MTP JOINTS TRIAL
The FORT trial (Foot ORthoses for big Toe joint osteoarthritis) is a two-arm participant- and assessor-blinded, multi-site RCT conducted in Melbourne, Sydney, Brisbane and the Gold Coast, Australia. This clinical trial aimed to determine whether contoured foot orthoses lead to greater reductions in first MTP joint pain on walking compared to sham flat insoles in people with first MTP joint OA. Foot orthoses are a common non-drug, non-surgical strategy used by allied health professionals for people with first MTP joint OA, however, it is unknown whether these devices are effective in improving the symptoms associated with the condition.
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Non-drug, non-surgical treatments are recommended by OA clinical guidelines, yet there have only ever been two randomised controlled trials (RCTs) evaluating such strategies in people with first MTP joint OA. Institution: The Wellington Hospital, London, UK.Ĭlinicians should seek clarification on whether any implant demonstrated is licensed for use in their own country.First metatarsophalangeal (MTP) joint osteoarthritis (OA) is a painful and debilitating condition affecting nearly one in 10 people aged over 50 years. If a minimally invasive technique is used the objectives are broadly the same though the execution different.Ī release can also be done in a more limited fashion by dissecting through the lateral aspect of the joint. This technique can also be used in the correction of severe deformity using a first MTP fusion and a mild Hallux valgus. This is one key step in the correction of moderate and severe Hallux valgus deformities. The open lateral release technique demonstrated here is the commonest way of mobilising the lateral aspect of the first Metatarso-phalangeal joint. Our e-learning platform contains high resolution images and a certified CME of the Hallux valgus: Lateral MTP joint release ( modified McBrides procedure) surgical procedure. Learn the Hallux valgus: Lateral MTP joint release ( modified McBrides procedure) surgical technique with step by step instructions on OrthOracle.
MTP JOINTS FULL
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