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.