Debridement of painful forefoot plantar callosities in rheumatoid arthritis

NewsBot · Dec 19, 2012

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Debridement of painful forefoot plantar callosities in rheumatoid arthritis: the CARROT randomised controlled trial.
Siddle HJ, Redmond AC, Waxman R, Dagg AR, Alcacer-Pitarch B, Wilkins RA, Helliwell PS.
Clin Rheumatol. 2012 Dec 18

The objective of this study was to evaluate the long-term benefits of sharp scalpel debridement of painful forefoot plantar callosities in rheumatoid arthritis (RA). The null hypothesis: sharp scalpel debridement would offer no additional long-term advantage in terms of pain and function. Sixty-five people with RA were randomised to receive regular sharp scalpel debridement of painful forefoot plantar callosities in conjunction with a combined therapeutic approach or a combined therapeutic approach alone. The primary outcome measure was change at 18 months in participant-reported forefoot plantar pain measured by a 100-mm visual analogue scale (VAS). Secondary outcome measures were recorded at baseline and study exit and included revised Foot Function Index, Health Assessment Questionnaire, Foot Impact Scale and gait parameters. At 18 months, there were no differences between groups for the primary outcome VAS-measured forefoot plantar pain (left foot (F = 0.23, p = 0.635), right foot (F = 2.14, p = 0.148)). Within-group changes were highly significant (treatment arm, difference = 16.9 (95 % confidence interval (CI) 9.4, 24.4), t = 4.6, p < 0.0001; control arm, difference = 17.5 (95 % CI 9.4, 25.5), t = 4.4, p < 0.0001). There was little change in scores of overall function and foot impact in either group and there were no significant changes in gait parameters noted. The long-term effects of sharp scalpel debridement of painful forefoot plantar callosities in people with RA, when used in conjunction with a combined therapeutic approach, produced no additional benefit over the combined therapeutic approach alone
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Admin2 · Dec 19, 2012

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Paul Bowles · Dec 19, 2012

Nice! So does this mean I don't have to debride their forefoot callous when they come into my office? Bonus! Another time saver.

drsha · Dec 25, 2012

NewsBot said: ↑

Debridement of painful forefoot plantar callosities in rheumatoid arthritis: the CARROT randomised controlled trial.
Siddle HJ, Redmond AC, Waxman R, Dagg AR, Alcacer-Pitarch B, Wilkins RA, Helliwell PS.
Clin Rheumatol. 2012 Dec 18
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in this study, was the debrided callus sent for pathology to see the depth of debridement.

Was any viable tissue debrided?

Was local anesthesia employed?

Dennis

Craig Payne · Dec 26, 2012

drsha said: ↑

in this study, was the debrided callus sent for pathology to see the depth of debridement.
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No.

Was any viable tissue debrided?
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No.

Was local anesthesia employed?
Click to expand...

No.

I don't see why they would do any of that. The interventions used in the clinical trial were just mimicking typical or standard clinical practice.

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