Clinical Examination of Cavovarus Feet

NCT07644078 | Recruiting

• 2 other identifiers: 26/PR/0552371432
• Study Type: observational
• Target: 30
• Locations: 1 country
• Sites: 1

Brief Summary

Cavovarus feet are complex deformities in multiple planes. There is little consensus on the best way to address deformities. Furthermore there are various different phenotypes and we have previously described 4 distinct forefoot morphotypes that exist. It has been hypothesised that the various morphotypes could benefit from differing surgical strategies. However, identification of forefoot morphotypes has only been possible thus far using specialised semi-automated software and 3D animating software to manually identify morphotypes. It is therefore not straightforward to identify which patients may benefit from which surgery and this is not translatable to surgeons outside of a specialist centre. The utility of this classification has been thus far limited to research. There is a burning need to explore ways in which identification of forefoot morphotypes can be translated to other centres using techniques such as basic imaging or clinical examination to identify patients with different morphotypes. At Royal National Orthopaedic Hospital (RNOH) we have a large, complex cohort of patients with neuromuscular foot and ankle deformity and cavovarus feet. We also have access to advanced imaging techniques which we employ in routine care of our patients. We further have access to the software and previous research tools used to identify forefoot morphotypes. We have for many years been examining cavovarus feet and documenting the various clinical findings. We also run teaching clinics combined with registrars where patients are routinely examined as part of routine care and pre-operative work up. Therefore we are ideally and uniquely placed to carry out this research which is an extension of our previous work. Our primary aim is to identify a reproducible method of distinguishing between the various forefoot morphotypes in cavovarus feet in patients with Charcot Marie Tooth disease (CMT). This will include investigating the utility of clinical examination and manual measurements (without specialised software) on weightbearing CT (WBCT). We will also aim to examine the reproducibility of any techniques such as clinical examination.

Conditions

Cavus Foot

Outcome Measures

Primary Outcomes (1)

• Assessment of reproducibility of clinical examination

  6 months

Study Arms (1)

Cavovarus Feet

Patients with cavovarus feet and Charcot Marie Tooth

Other: Clinical Examination

Interventions

Clinical Examination OTHER

Clinical examination as part of routine care

Cavovarus Feet

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Patients with CMT and cavovarus feet

You may qualify if:

• Adult patients aged ≥ 18 years
• Clinical diagnosis of cavovarus foot deformity, AND confirmed Charcot-Marie-Tooth disease or other hereditary sensorimotor neuropathy
• Already under the care of the Foot \& Ankle Unit at RNOH.
• Additionally, for PROSPECTIVE element:
• Capacity to provide written informed consent
• Additionally, for the RETROSPECTIVE element:
• Previously assessed for cavovarus feet at RNOH
• Forefoot morphotype previously identified using Disior Bonelogic software
• Clinical examination findings documented in medical notes.

You may not qualify if:

• Previous surgery to the hindfoot or midfoot
• Age under 18 years
• For the PROSPECTIVE element:
• Unable to consent
• For the RETROSPECTIVE element:
• Participant has previously withdrawn consent for use of their data in line with NHS Opt-out
• Insufficient clinical examination data recorded in medical notes.

Sponsors & Collaborators

• Royal National Orthopaedic Hospital NHS Trust: lead

Study Sites (1)

Royal National Orthopaedic Hospital

Stanmore, HA7 4LP, United Kingdom

RECRUITING

MeSH Terms

Conditions

Talipes Cavus

Interventions

Restraint, Physical

Condition Hierarchy (Ancestors)

Talipes; Foot Deformities, Acquired; Foot Deformities; Musculoskeletal Diseases; Foot Deformities, Congenital; Lower Extremity Deformities, Congenital; Limb Deformities, Congenital; Musculoskeletal Abnormalities; Congenital Abnormalities; Congenital, Hereditary, and Neonatal Diseases and Abnormalities

Intervention Hierarchy (Ancestors)

Behavior Control; Therapeutics; Immobilization; Investigative Techniques

Study Officials

• Karan Malhotra

  Consultant Orthopaedic Surgeon

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Karan Malhotra

CONTACT

+442039470272; k.malhotra@nhs.nbet

Ira Jakupovic

CONTACT

+442039470272; ira.jakupovic1@nhs.net

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Target Duration: 1 Day
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: June 8, 2026
• First Posted: June 12, 2026
• Study Start: May 28, 2026
• Primary Completion (Estimated): August 1, 2026
• Study Completion (Estimated): December 31, 2027
• Last Updated: June 12, 2026

Record last verified: 2026-06

Data Sharing

• IPD Sharing: Will not share

Locations

GB (1)