An interventional study of Debridement of the MTP1 cartillage lesion and microfracture in Hallux Valgus and Cartilage Damage, sponsored by Tom Lootens. Recruiting at 1 site in Belgium. Open to participants aged 30 Years to 60 Years. Per ClinicalTrials.gov, last updated 2025-03-12.
Sponsored by Tom Lootens · Not applicable, Interventional, and Treatment
The aim of this study is to investigate the point or nonsense of treating cartilage lesions at the level of the first metatarsophalane joint. To date, no clear guidelines have been found in the literature with regard to the treatment of cartilage lesions at the MTP I joint during corrective surgery for hallux valgus, nor has it been investigated whether this can have an effect on the clinical outcome.
A randomized, single surgeon study in which two groups will be compared with each other:
Group 1: 50 patients in whom no treatment of the cartilage lesions is performed: these patients have no cartilage lesion or a grade I cartilage lesion at the MTP I joint that has been found to be operative. The grade of the cartilage lesions will be determined on the basis of the ICRS scale and an MS Hololens.
Group 2: 50 patients with a cartilage lesion> grade 1 found during surgery. Whether or not to treat the cartilage injury will be randomly determined. 50 envelopes will be made with 25 treat, 25 not to treat. Just before surgery, Dr. T. Lootens an envelope will be drawn which will determine the further policy of the operation:
Group 2A: 25 patients who are not treated for the cartilage injury. Group 2B: 25 patients who are treated for the cartilage injury by means of debridement of the lesion and microfracture.
The patients who will undergo surgery for hallux valgus will be seen pre-operatively at the outpatient clinic by the investigators. During this consultation, an explanation will be given about the research and the participant will have to sign an informed consent before participating in the study. Here, the participant will also receive an envelope with questionnaires (AOFAS score / SF 36 score / VAS pain and satisfaction), which they will fill out on the day of surgery.
Follow up The participants will be seen again at the orthopedics outpatient clinic for clinical follow-up and filling out questionnaires at 10 days, 5 weeks, 4 months and 1 year postoperatively. This follow up will be done by the co-investigator, who is blinded during the study.
Scientific foundation Corrective hallux valgus surgery currently exists in two ways: open and closed (percutaneous) technique. To date, there is no consensus on the treatment of visible cartilage lesions at the MTP I joint during the open technique. It is not known whether or not treating these injuries has an impact on the patient's clinical outcome. The Principle investigator already treats the serious cartilage lesions (> GR1 lesions) by means of debridement of the lesion, followed by microfracture. As there is no literature available on this topic yet, this research could certainly add value for the therapeutic approach of cartilage lesions at MTP I in the future.
Moreover, if microfracture gives a significantly better clinical outcome, this means that the closed (percutaneous) technique is contraindicated as a corrective technique in patients with hallux valgus. If this is not the case, no cartilage lesions at the level of the MTP I joint need to be taken into account during open technique.
144 studies on the registry are indexed under Hallux Valgus; 31 are open to participants now.
This study's planned enrollment of 99 is above the median of 56 across 106 interventional studies indexed under Hallux Valgus.
Browse Hallux Valgus studies →This is the only study on the registry with Tom Lootens as lead sponsor.
Counted across the registry records on this site, refreshed daily.
Exclusion Criteria:
Patients in whom no treatment of the cartilage lesions is performed: these patients have no cartilage lesion or a grade I cartilage lesion at the MTP I joint that has been found peroperatively. The degree of the cartilage lesions will be determined on the basis of the ICRS scale and an MS Hololens.
Patients in whom a cartilage lesion\> grade 1 is found during surgery randomised in the no treatment group
Patients in whom a cartilage lesion\> grade 1 is found during surgery randomised in the treatment group. They will be treated through debridement of the lesion and microfracture.
Procedure: Debridement of the MTP1 cartillage lesion and microfracture
Patients with a MTP1 cartillage lesion \> grade I (based on based on the ICRS scale and an MS HoloLens measurement) randomised in the treatment group will be treated with debridement and microfracture
Change in AOFAS
American Orthopaedic Foot and Ankle Society (AOFAS) score - combines a clinician-reported and a patient-reported part for measuring the outcome of treatment in patients who sustained a complex hindfoot injury based on pain, function and alignment: 0 (bad outcome) to 100 (very good outcome)
Time frame: 10 days, 5 weeks, 4 months, 1 year
Change in SF36
Short Form 36 (SF-36) Health Survey - consists of eight scaled scores, which are the weighted sums of the questions in their section. Each scale is directly transformed into a 0-100 scale on the assumption that each question carries equal weight. The lower the score the more disability. The higher the score the less disability i.e., a score of zero is equivalent to maximum disability and a score of 100 is equivalent to no disability.
Time frame: 10 days, 5 weeks, 4 months, 1 year
Change in VAS pain
Visual Analogue Scale pain score - 0 (no pain) to 10 (worse pain)
Time frame: 10 days, 5 weeks, 4 months, 1 year
Change in VAS Patient satisfaction
Visual Analogue Scale Patient satisfaction score - 0 (not satisfied at all) to 10 (very satisfied)
Time frame: 10 days, 5 weeks, 4 months, 1 year
Plan to share: No
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