Treatment of Hallux Rigidus (HARD)
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The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details. |
ClinicalTrials.gov Identifier: NCT04590313 |
Recruitment Status :
Not yet recruiting
First Posted : October 19, 2020
Last Update Posted : October 19, 2020
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Condition or disease | Intervention/treatment | Phase |
---|---|---|
Hallux Rigidus | Procedure: Arthrodesis | Not Applicable |
Study Type : | Interventional (Clinical Trial) |
Estimated Enrollment : | 90 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Intervention Model Description: | A randomised, controlled trial will be performed by allocating 40 years or older patients with symptomatic hallux rigidus to arthrodesis or watchful waiting group in a ratio of 1:1. |
Masking: | Single (Outcomes Assessor) |
Masking Description: | To avoid biased interpretation of the trial data, blinded data interpretation will be used in the reporting of the results of this trial (70). Before accessing the primary outcome data, the writing committee will record a 'Background assumptions' document containing our definition of MID of the outcome measures, and a brief summary of the key statistical analysis used in the evaluation of the outcome data. The document will be signed by the members of the writing committee and published as an appendix to the primary publication. |
Primary Purpose: | Treatment |
Official Title: | Treatment of Hallux Rigidus (HARD): A Prospective, Randomised, Controlled Trial of Arthrodesis Versus Watchful Waiting in the Treatment of Hallux Rigidus |
Estimated Study Start Date : | November 1, 2020 |
Estimated Primary Completion Date : | November 1, 2024 |
Estimated Study Completion Date : | November 1, 2028 |
Arm | Intervention/treatment |
---|---|
Active Comparator: Arthrodesis
MTPJ I Arthrodesis
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Procedure: Arthrodesis
MTPJ I arthrodesis |
No Intervention: Watchful waiting
No intervention, patient information leaflet
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- Pain during walking in Numerical Rating Scale (NRS) [ Time Frame: 1 year after randomisation ]scale 0-10; 0=no pain, 10=worst pain
- Pain during rest in Numerical Rating Scale (NRS) [ Time Frame: 6 months, 1year, 2 years, 5 years ]scale 0-10; 0=no pain, 10=worst pain
- Pain during walking in Numerical Rating Scale (NRS) [ Time Frame: 6 months, 2 years, 5 years ]scale 0-10; 0=no pain, 10=worst pain
- Patient Related Outcome [ Time Frame: 6 months, 1year, 2 years, 5 years ]MOXFQ-score, Scale 0-100
- Patient reported quality of life [ Time Frame: 6 months, 1year, 2 years, 5 years ]EQ-5D-5L, Scale 0-100
- Complications [ Time Frame: 6 months, 1year, 2 years, 5 years ]Number of minor and major adversary effects
- Patient Acceptable Symptom State [ Time Frame: 6 months, 1year, 2 years, 5 years ]Percentage of patients with acceptable symptom state (PASS)

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Ages Eligible for Study: | 40 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Age 40 years or over
- Diagnosis of hallux rigidus: Persistent pain on movement of the first MTPJ AND Osteoarthritic first MTPJ in plain X-rays
- Duration of symptoms ≥1 year
- Pain-NRS during walking of 4 or more on a scale 0-10 (higher is worse)
- No substantial pain in other joints of the foot in clinical examination
- Willingness to accept both treatment options
- Ability to understand trial information and answer outcome assessments in Finnish
- Signed informed consent
Exclusion Criteria:
- ASA* physical status classification level III or higher
- Patients with weak co-operation (dementia, schizophrenia, etc.)
- Patients with neuropathy, i.e. unable to feel 10g monofilament pressure in less than 8 out of 10 standard testing sites
- Active bacterial infection or ulcer of the lower limb
- Diabetes mellitus with insulin treatment
- Diabetes mellitus and GHb-A1C >64 mmol/mol (regardless of treatment)
- History of rheumatoid arthritis, gout or other inflammatory arthritis of the foot
- Hallux valgus angle >15° in weight-bearing X-ray
- Hallux varus in weight-bearing X-ray
- Large bone cysts in X-ray probably requiring bone grafting in surgery
- Pain in passive manipulation of ipsilateral first toe IP joint
- Patients with severe circulatory disorder of the lower limb: absence of palpable pulses in the foot (both dorsalis pedis artery and tibialis posterior artery)
- History of surgery of the foot in question
- Activity limiting symptoms from an earlier fracture or ligament injury of the foot
- Patient is not willing to accept the operation within the planned time limits (3 to 12 weeks post-randomisation)

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04590313
Contact: Mikko Miettinen, M.D. | +35894711 | mikko.miettinen@hus.fi | |
Contact: Jussi Repo, M.D., Ph.D. | +35894711 | mrjussirepo@gmail.com |
Finland | |
Helsinki University Hospital | |
Helsinki, Finland, 00029 HUS | |
Contact: Mikko Miettinen, M.D. +35894711 mikko.miettinen@hus.fi |
Study Director: | Jussi Repo, M.D., Ph.D. | Hospital District of Helsinki and Uusimaa |
Responsible Party: | Mikko Miettinen, Consultant orthopaedic surgeon, M.D., Hospital District of Helsinki and Uusimaa |
ClinicalTrials.gov Identifier: | NCT04590313 |
Other Study ID Numbers: |
39§/30.9.2020 |
First Posted: | October 19, 2020 Key Record Dates |
Last Update Posted: | October 19, 2020 |
Last Verified: | October 2020 |
Individual Participant Data (IPD) Sharing Statement: | |
Plan to Share IPD: | No |
Studies a U.S. FDA-regulated Drug Product: | No |
Studies a U.S. FDA-regulated Device Product: | No |
Hallux Rigidus Hallux Limitus Foot Deformities, Acquired Foot Deformities Musculoskeletal Diseases |
Joint Diseases Foot Injuries Leg Injuries Wounds and Injuries |