Tarva Trial - Current Research

The Tarva Trial

Ankle replacement Surgery vs ankle fusion : A five year study which is  due to end in May 2020 with patients taking part around the country in 17 NHS hospitals.

More than 29000 patients in the UK see specialists each year with Ankle Osteoarthritis symptoms which can cause major disability in patients and greatly impacts their quality of life.
In the early stages of this disease patients are asked to manage their disease through non-operative measures such as a change in activity levels, weight loss, physiotherapy, pain killers and ankle braces may be used,  surgery is considered only once all these measure are no longer effective.

There are two types of surgery options, ankle fusion and ankle total replacement.

Both ankle fusion and total ankle replacement are good treatments to relieve pain, and each has its own advantages, but we do not know which option patients prefer. The purpose of the TARVA study is to scientifically demonstrate which treatment, fusion or total ankle replacement, provides better results for patients.

To do this, 310 patients with end-stage ankle osteoarthritis aged 50-85 years  are being invited to take part from UK NHS hospitals and randomly allocated on an equal basis to receive one of the two treatments. Patients will attend routine follow-up visits at their hospital at 2, 6, 12, 26 and 52 weeks after their surgery.

Patients are asked to complete a questionnaire at certain visits and have the range and movement of their foot and ankle measured. The overall aim is to compare the improvement in pain free function before surgery to one year after surgery.

Patricia Perks

Patricia heard about the TARVA Trial following her knee surgery check-up appointment. She was asked if she had any questions and although her knee was healing really well, she asked if anything could be done to help her with the pain in her ankle. The clinician said she would write to her GP so she could be referred to Southmead to investigate whether she would be suitable for ankle replacement surgery or ankle fusion.
“When I came to see Mr Winson, he invited me to take part in a trial to compare ankle replacement surgery and ankle fusion. He also explained that it was a randomised trial which meant that I would be chosen at random for one or the other.
I thought it was absolutely brilliant. I had never heard of either so I was all for it as it was an operation that was going to help me, so I said yes.
What was really reassuring about taking part in the trial was that I was told, even though I was randomised, right up until the day of the operation on the operating table, if they decided that the one I had been randomised into would not be suitable, they would pull me from the trial and do the most appropriate surgery for me.  In the end I had an ankle replacement.
I was introduced to Liz who is the Research Nurse for the trial. She went through the paperwork with me and my daughter. Liz also made sure that any additional paperwork involved with the trial was timed with my outpatient appointments which meant we didn’t have any additional trips to make to the hospital to take part in the trial.
I have nothing but praise for Liz, she has been fantastic. Following my operation I had a plaster up to my knee for two weeks, then another plaster for four weeks, so I was moving around using a zimmer frame with my bed downstairs.  I was itching to have a shower which was upstairs so needed a walking stick to get upstairs.  I rang numerous people trying to find information about where to get a walking stick. In the end I rang Liz and she was able to sort one for me.
I rely on my daughter to bring me into hospital. Liz has also been able to arrange my outpatient appointments around my daughter’s shifts which has been really helpful.

What would you say to one of your friends who is thinking about taking part in research?
"I would say go for it.  To be honest I have nothing but praise for everything they do. They have been absolutely brilliant. My ankle is constantly improving day by day".