A comparison of postoperative footwear following forefoot surgery. A randomised control trial

K. Robinson, F. Harrold, A. Fox, C. Chadwick, C. Blundell, M. Davies

Introduction: Following forefoot surgery patients are put into an accommodative shoe for 6 weeks. Although there are various postoperative shoes available, no studies have compared these shoe for patient satisfaction, effectiveness of pain relief or relative cost. This study looks at three types of footwear, testing the null hypothesis that there is no difference in patient satisfaction or performance between post-operative shoes.

Method: NREC permission was granted for this Prospective Randomised Control Trial (12/yh/0110). Eligible patients (aged over 18, undergoing straightforward 1st ray surgery and independently mobile) were recruited from clinic by senior authors. Thirty of each footwear type (Procare Med/Surg Shoe, Darco shoe, Podalux shoe) were randomly allocated to 90 envelopes. Patients completed a pre-operative MOXFQ and were allocated a study number. Post surgery, each patient was randomly allocated one of the envelopes and fitted with the respective shoe prior to discharge. Patients were seen 6 weeks post-operatively and completed a post-operative MOXFQ and Surgical Shoe Questionnaire. Statistical analysis was carried out with a significance level set at p< 0.05.

Results: There was no significant difference between postoperative means, for the MOXFQ walking/standing domain (p = 0.6789), pain (p = 0.5204) or social interaction (p = 0.6740). There was no significant difference between the mean values for each shoe for the Surgical Shoe Questionnaire (p = 0.2980), nor in willingness of patients to wear the shoe again (p = 0.3681).

Conclusion: We accept our null hypothesis that there is no difference in patient satisfaction or performance between post-operative shoes. Patients were found to be equally satisfied with wearing any of the post-operative shoes. Provided that clinical outcome is not affected by wearing any particular shoe, the clinician is free to choose the most cost effective option or the shoe they feel is best suited to their patient.