Establishing the UK clubfoot research priorities : a multiple-stakeholder consensus study

Area of Science:

• Orthopedics
• Pediatric Medicine
• Clinical Research

Background:

• Clubfoot is the most common congenital foot deformity.
• The Ponseti method is effective but lacks rigorous evaluation of individual components, especially for maintaining correction.
• Limited high-quality evidence hinders optimal clinical decision-making in clubfoot management.

Purpose of the Study:

• To identify and prioritize research areas for clinical trials in clubfoot management.
• To establish evidence-based guidelines for treating congenital talipes equinovarus.
• To address the need for more rigorous evaluation of clubfoot treatment components.

Main Methods:

• A modified Delphi technique was employed, including surveys and consensus meetings.
• Key stakeholders, patients, and carers in the UK participated.
• The study followed a predefined protocol and reported using the ACCORD checklist.

Main Results:

• Nine research priorities were identified across four themes: Primary Treatment, Bracing, Relapse, and Physiotherapy.
• Relapse and Bracing emerged as the highest-scoring themes.
• The most significant priority identified was comparing the effectiveness of unilateral versus bilateral bracing.

Conclusions:

• This study successfully identified critical research priorities for clubfoot management.
• These priorities will guide the development of multicenter clinical trials.
• The findings aim to enhance evidence-based practices and improve treatment outcomes for individuals with clubfoot.