Follow-up and Outcome of Operative Treatment With Decompressive Release Of The Peroneal Nerve

Last updated: June 28, 2024
Sponsor: Universitaire Ziekenhuizen KU Leuven
Overall Status: Active - Recruiting

Phase

N/A

Condition

N/A

Treatment

Maximal physiotherapy

Neurolysis peroneal nerve

Clinical Study ID

NCT04695834
S62895
KCE19-1232
  • Ages > 18
  • All Genders

Study Summary

The FOOT DROP trial is a prospective, multi-center, randomized controlled trial to assess if decompressive surgery for peroneal nerve entrapment is superior to maximal conservative treatment.

Patients with persisting foot drop due to peroneal nerve entrapment will be randomized to either surgery or conservative treatment if foot drop persists 10 +/- 4 weeks after onset of symptoms.

Patients will be evaluated through several questionnaires, evolution of muscle strength and several types of gait assessments. Primary endpoint is the difference in distance covered during the six minute walking test between baseline and 9 months after randomization.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • Written informed consent to participate in the study must be obtained from thesubject or proxy / legal representative prior to initiation of any study-mandatedprocedure

  • EDX-documented peroneal nerve entrapment with persisting (10 ± 4 weeks) foot drop (MRC-score ≤ 3)

  • Imaging (ultrasound/MRI) performed to exclude a compressive mass

  • Age ≥ 18 years

Exclusion

Exclusion Criteria:

  • Subjects with posttraumatic or iatrogenic peroneal nerve injury

  • Subjects with peroneal neuropathy due to a compressive mass (e.g. cyst, tumour)

  • Peroneal nerve entrapment at other sites than the fibular head

  • Patients with mental or physical problems that incapacitate them to participate in aphysiotherapy program

  • Psychiatric illness

  • Pregnancy

  • Planned (e)migration within 1 year after randomization to another country

  • Subjects with previous foot drop

  • Permanently bedridden subjects

  • Subjects with neurological or musculoskeletal history which could impact foot dropassessment and/or gait analysis (e.g. polyneuropathy, hereditary neuropathy withpressure palsies, critical illness polyneuropathy, previous stroke, ankle surgery, ...).

Study Design

Total Participants: 182
Treatment Group(s): 2
Primary Treatment: Maximal physiotherapy
Phase:
Study Start date:
April 28, 2021
Estimated Completion Date:
December 31, 2028

Study Description

The Foot Drop Trial is the first prospective, randomised controlled trial to investigate the treatment of foot drop in peroneal nerve entrapment. Currently, the literature consists mostly of biased retrospective case series with the exception of some small (biased) prospective case series. No comparative trials have been conducted. The goal of the trial is to assess whether foot drop due to peroneal nerve entrapment recovers better 9 months after decompressive surgery compared to maximal conservative treatment.

Patients with persisting foot drop (MRC score ankle dorsiflexion ≤ 3) after 10 +/- 4 weeks after onset of symptoms will be randomised to either decompressive surgery within 1 week after randomisation or maximal conservative treatment focussing on physiotherapy and gait rehabilitation. Blinded outcome assessors will evaluate participants at study visits 10 days (surgical group), 6 weeks, 3 months, 6 months, 9 months (primary outcome) and 18 months (extended follow-up) after randomization.

Outcome assessors will conduct several assessments to evaluate gait improvement (6-minute walk test, 10-meter walk test, Stanmore questionnaire, functional ambulation categories, ability to walk barefoot, need for foot-ankle orthosis), muscle strength (MRC score for ankle dorsiflexion, ankle eversion, hallux extension) , quality of life (EQ-5D 5L) and cost-effectiveness of both treatment strategies (work productivity and activity impairment questionnaire (WPAI), return to work, percentage of invalidity). Electrodiagnostic follow-up will be registered at 3 months and 9 months after randomization.

The primary endpoint of the foot drop trial is the difference in distance covered in meters during the six-minute walk test (6MWD) between baseline and 9 months after randomization. Time to recovery, defined as the time necessary to cover the minimal age- and sex-specific normal 6MWD AND the time necessary for foot drop recovery to an MRC-score ≥ 4 for ankle dorsiflexion is the key secondary endpoint. No cross-over to surgery is allowed before primary endpoint is reached.

The study first succesfully piloted in 6 centers in Belgium and the Netherlands and is currently starting on a large scale in 20 centers.

Connect with a study center

  • AZ Sint-Maarten

    Mechelen, Antwerpen 2800
    Belgium

    Site Not Available

  • AZ Turnhout

    Turnhout, Antwerpen 2300
    Belgium

    Site Not Available

  • Sint Augustinus

    Wilrijk, Antwerpen 2610
    Belgium

    Site Not Available

  • Jessa Ziekenhuis

    Hasselt, Limburg 3500
    Belgium

    Site Not Available

  • AZ Vesalius

    Tongeren, Limburg 3717
    Belgium

    Site Not Available

  • AZ Alma

    Eeklo, Oost-Vlaanderen 9900
    Belgium

    Site Not Available

  • AZ Sint-Lucas

    Gent, Oost-Vlaanderen 9000
    Belgium

    Site Not Available

  • AZ Sint-Jan

    Brugge, West-Vlaanderen 8000
    Belgium

    Site Not Available

  • AZ Groeninge, department of neurosurgery

    Kortrijk, West-Vlaanderen 8500
    Belgium

    Active - Recruiting

  • AZ Damiaan

    Oostende, West-Vlaanderen 8400
    Belgium

    Site Not Available

  • AZ Delta

    Roeselare, West-Vlaanderen 8800
    Belgium

    Site Not Available

  • Universitaire Ziekenhuizen Antwerpen

    Antwerpen, 2000
    Belgium

    Site Not Available

  • UZ Brussel

    Brussel, 1000
    Belgium

    Site Not Available

  • ULB Erasme, department of neurosurgery

    Brussels, 1000
    Belgium

    Active - Recruiting

  • Ziekenhuis Oost-Limburg, department of neurosurgery

    Genk, 3600
    Belgium

    Active - Recruiting

  • University Hospitals Of Leuven, department of neurosurgery

    Leuven, 3000
    Belgium

    Active - Recruiting

  • CHU de Liège, department of neurosurgery

    Liège, 4000
    Belgium

    Active - Recruiting

  • Leids Universitair Medisch Centrum, department of neurosurgery

    Leiden, 2333
    Netherlands

    Active - Recruiting

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