TARVAHealth technology assessment (Winchester, England) 2023
Total ankle replacement versus ankle arthrodesis for patients aged 50-85 years with end-stage ankle osteoarthritis: the TARVA RCT.
Both groups improved substantially, with no statistically significant difference in the primary outcome at 52 weeks between replacement and arthrodesis.
Randomised trialManagementFoot & ankle
AIR trial (cast vs removable brace)BMJ (Clinical research ed.) 2021
Use of cast immobilisation versus removable brace in adults with an ankle fracture: multicentre randomised controlled trial.
There was no statistically significant or clinically important difference in OMAS at 16 weeks between brace and cast, nor in secondary analyses.
Randomised trialManagementFoot & ankle
UKSTARLancet (London, England) 2020
Plaster cast versus functional brace for non-surgical treatment of Achilles tendon rupture (UKSTAR): a multicentre randomised controlled trial and economic evaluation.
There was no significant difference in ATRS at 9 months between the brace and cast groups, and re-rupture rates were similar. The brace was not shown to be clinically superior.
Randomised trialManagementFoot & ankle
AIMJAMA 2016
Close Contact Casting vs Surgery for Initial Treatment of Unstable Ankle Fractures in Older Adults: A Randomized Clinical Trial.
Close contact casting gave ankle function equivalent to surgery on OMAS at 6 months. Casting had fewer infection and wound problems but more radiological malunion, and a minority of casting patients converted to surgery after early loss of reduction.
Randomised trialManagementFoot & ankle
UK HeFTBMJ (Clinical research ed.) 2014
Operative versus non-operative treatment for closed, displaced, intra-articular fractures of the calcaneus: randomised controlled trial
There was no significant difference in Kerr-Atkins score at 2 years, and the operative group had more complications and reoperations.
Randomised trialManagementFoot & ankle
Willits Achilles RCTThe Journal of bone and joint surgery. American volume 2010
Operative versus nonoperative treatment of acute Achilles tendon ruptures: a multicenter randomized trial using accelerated functional rehabilitation.
Re-rupture rates were low and not significantly different between groups, and there was no significant difference in strength, function or range of movement. Surgery carried more complications, mainly wound-related.
Randomised trialManagementFoot & ankle
CAST ankle sprain trialLancet (London, England) 2009
Mechanical supports for acute, severe ankle sprain: a pragmatic, multicentre, randomised controlled trial
A short period in a below-knee cast gave a faster recovery than tubular bandage, with the Aircast brace also beneficial; the Bledsoe boot did not show benefit. Differences narrowed by 9 months.
Randomised trialManagementFoot & ankle
Ottawa rules meta-analysisBMJ (Clinical research ed.) 2003
Accuracy of Ottawa ankle rules to exclude fractures of the ankle and mid-foot: systematic review
Sensitivity was almost 100% with low negative likelihood ratios for ankle and midfoot in adults and children, so a negative rule makes fracture very unlikely; specificity was only modest.
Systematic review / meta-analysisDiagnosisFoot & ankle
Torkki hallux valgus RCTJAMA 2001
Surgery vs orthosis vs watchful waiting for hallux valgus: a randomized controlled trial
Surgery gave significantly less pain and better function and satisfaction at 12 months than orthoses or waiting. Orthoses gave only short-term symptom relief.
Randomised trialManagementFoot & ankle
Ottawa ankle rulesJAMA 1993
Decision rules for the use of radiography in acute ankle injuries. Refinement and prospective validation
The refined rules detected essentially all clinically significant malleolar and midfoot fractures in validation, while allowing a substantial reduction in radiography.
Cohort studyDiagnosisFoot & ankle