PROSPECTIVE RANDOMIZED CONTROLLED TRIAL TO EVALUATE THE EFFECT OF WEIGHT BEARING ON PATIENT OUTCOMES FOLLOWING FIRST METATARSOPHALANGEAL JOINT FUSION
Bibliographic record
Abstract
Introduction: First Metatarsophalangeal (MTP) joint arthrodesis is a common procedure for the treatment of hallux rigidus and severe hallux valgus with osteoarthritis. Despite its commonality, post-operative weight bearing protocols vary widely. To date, no prospective randomised controlled trials have directly compared outcomes between immediate weight bearing as tolerated (WBAT) and non-weight bearing (NWB) following 1st MTP fusion. Method: A prospective randomised controlled trial was conducted with 68 patients undergoing isolated 1st MTP fusion, allocated to WBAT or NWB. Standardised surgical technique and fixation methods (screws or plate) were performed by two fellowship-trained foot and ankle surgeons. Primary outcomes were pain measured by the Visual Analogue Scale (VAS) and function measured by the Foot & Ankle Ability Measure, (FAAM–ADL subscale) at 12 months. Secondary outcomes included non-union, complication, and patient satisfaction. Statistical analysis used t-tests and chi-squared or Fisher's exact tests, with significance at p<0.05. Results: Sixty-eight patients (33 WBAT, 35 NWB) completed the study. At a minimum 12 months follow-up, both groups demonstrated significant improvements in pain and function. No statistically significant differences were found between WBAT and NWB groups in VAS pain scores (2.97+/-2.215 vs 2.54+/-2.147; p=0.423), FAAM scores (81.31+/-16.028 vs 85.02+/-18.863; p=0.387), or patient satisfaction (8.00+/-2.76 vs 8.34+/-2.52; p=0.594). Complication rates were comparable, with one case of hardware irritation in each group (p=0.739). Plate fixation was more common in the NWB group (p=0.028), this is unlikely to affect outcomes. Conclusion: Immediate weight bearing following 1st MTP fusion is safe and results in equivalent pain relief, function, satisfaction, and complication rates, compared to traditional NWB protocols. These findings support a shift toward more permissive postoperative strategies, with potential benefits for patient mobility, independence, recovery time, and healthcare resource use.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.014 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.006 | 0.003 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.004 | 0.003 |
| Insufficient payload (model declined to judge) | 0.013 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".