Chronic Insertional Achilles Tendonitis Treated With or Without Flexor Hallucis Longus Tendon Transfer
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Purpose
The purpose of this study is to determine whether Achilles tendon debridement and decompression augmented with flexor hallucis longus (FHL) tendon transfer results in improved clinical and functional outcome as measured by ankle plantar flexion strength and American Orthopedic Foot and Ankle Society (AOFAS) score compared to debridement and decompression alone in patients over 50 years of age with chronic insertional Achilles tendinosis.
H0: There will be no difference in ankle plantar flexion strength measured using a handheld dynamometer between patients randomized to achilles tendon decompression and debridement alone (Group 1) and patients randomized to achilles tendon decompression and debridement augmented with FHL transfer (Group 2).
HA: Patients randomized to achilles tendon decompression and debridement alone (Group 1) will have less ankle plantar flexion strength compared to patients randomized to achilles tendon decompression and debridement augmented with FHL transfer (Group 2).
| Condition | Intervention | Phase |
|---|---|---|
|
Chronic Insertional Achilles Tendonitis |
Procedure: Achilles decompression & debridement Procedure: Achilles decompression and debridement with FHL transfer |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Chronic Insertional Achilles Tendonitis Treated With or Without Flexor Hallucis Longus Tendon Transfer: A Prospective, Randomized, Controlled Trial |
- ankle plantar flexion strength measured using a handheld dynamometer [ Time Frame: pre-operatively, 3 months, 6 months, and 1 year ] [ Designated as safety issue: No ]
- American Orthopaedic Foot and Ankle Society(AOFAS) Ankle-Hindfoot score [ Time Frame: pre-operatively, 3 months, 6 months, and 1 year ] [ Designated as safety issue: No ]
- Visual analog pain scale (VAS) [ Time Frame: pre-operatively, 3 months, 6 months, and 1 year ] [ Designated as safety issue: No ]
- Hallux plantarflexion strength using the dynamometer [ Time Frame: pre-operatively, 3 months, 6 months, and 1 year ] [ Designated as safety issue: No ]
- Patient Satisfaction [ Time Frame: 1 year ] [ Designated as safety issue: No ]
- Surgical complications [ Time Frame: Date of Surgery ] [ Designated as safety issue: No ]
- Postoperative complications [ Time Frame: 3 months, 6 months, and 1 year ] [ Designated as safety issue: No ]
| Enrollment: | 52 |
| Study Start Date: | December 2008 |
| Study Completion Date: | June 2012 |
| Primary Completion Date: | June 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Active Comparator: Achilles decompression & debridement |
Procedure: Achilles decompression & debridement
Surgical intervention
|
|
Active Comparator: Achilles decompression,debride&FHLtransf
Achilles tendon decompression and debridement augmented with FHL transfer. The preferred skin incision will be followed by central-splitting Achilles debridement, resection of a Haglund's lesion if present and pathologic, followed by FHL harvest for patients in group 2. The fixation technique in group 2 will utilize an interference screw for the FHL. For all patients, the Achilles will be reattached with lateral and medial suture anchors (just distal to interference screw in FHL patients).
|
Procedure: Achilles decompression and debridement with FHL transfer
surgical intervention
|
Eligibility| Ages Eligible for Study: | 50 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Patients 50 years of age or older
- Patients diagnosed with chronic insertional Achilles tendonitis
- Failed greater than 3 months of conservative treatment (activity and shoe modification, heel lifts, non-steroidal anti-inflammatory medications, stretching exercises, and formal physical therapy)
Exclusion Criteria:
- Patients less than 50 years of age upon presentation
- Females of child-bearing potential
- Patients who have a history of ipsilateral Achilles tendon rupture
- History of infection in the same lower extremity
- Patients unable to undergo MRI scan
Contacts and Locations| United States, North Carolina | |
| OrthoCarolina, PA | |
| Charlotte, North Carolina, United States, 28203 | |
| Principal Investigator: | Bruce E Cohen, MD | OrthoCarolina, P.A. |
More Information
No publications provided
| Responsible Party: | OrthoCarolina Research Institute, Inc. |
| ClinicalTrials.gov Identifier: | NCT00950053 History of Changes |
| Other Study ID Numbers: | 120808A |
| Study First Received: | July 29, 2009 |
| Last Updated: | March 11, 2013 |
| Health Authority: | United States: Institutional Review Board |
Additional relevant MeSH terms:
|
Tendinopathy Bursitis Exostoses Muscular Diseases Musculoskeletal Diseases |
Tendon Injuries Wounds and Injuries Joint Diseases Hyperostosis Bone Diseases |
ClinicalTrials.gov processed this record on May 22, 2013