Operative Versus Non-operative Management of Rotator Cuff Tear

NCT ID: NCT00695981

Last Updated: 2024-08-22

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

NA

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2008-06-30

Study Completion Date

2028-06-30

Brief Summary

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This study aims at determining the effectiveness and cost-effectiveness of surgical management of full-thickness rotator cuff tears compared to conservative treatment. The research setting is prospective, randomised, and controlled.

The aim of the study is to search out evidence based data of indications for rotator cuff repair. The investigators also aim at offering patients the most efficient and effective treatment and reduce the number of operations that do not have sufficient effectiveness. The data obtained will facilitate developing guidelines for referrals to a specialist when rotator cuff tear is suspected.

The investigators hypothesize that there are subgroups of patients suffering from rotator cuff tears that benefit from surgery whereas other subgroups are best treated conservatively.

Detailed Description

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Subgroup analyses:

* age
* sex
* duration of symptoms
* presence of trauma before symptoms
* size of tear
* degenerative findings
* other findings in MRI or arthroscopy
* type of operation
* co-morbidities
* occupation
* pain (VAS)
* objective shoulder function
* activities of daily living

Conditions

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Rotator Cuff Tear

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Rotator cuff repair

Surgery following a 3 months period of active non-operative treatment

Group Type ACTIVE_COMPARATOR

Rotator cuff repair

Intervention Type PROCEDURE

Rotator cuff repair + physical therapy according to a standardized protocol

Conservative treatment

Physiotherapy according to a standardized protocol following a 3 months period of active non-operative treatment

Group Type ACTIVE_COMPARATOR

Conservative treatment

Intervention Type PROCEDURE

Physiotherapy according to a standardized protocol

Interventions

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Rotator cuff repair

Rotator cuff repair + physical therapy according to a standardized protocol

Intervention Type PROCEDURE

Conservative treatment

Physiotherapy according to a standardized protocol

Intervention Type PROCEDURE

Other Intervention Names

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Arthroscopic or open rotator cuff repair Physical therapy Non-operative treatment

Eligibility Criteria

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Inclusion Criteria

* age over 35 years old
* duration of symptoms at least three months despite of non-operative treatment
* the patient accepts both treatment options (operative and conservative)
* a full-thickness rotator cuff tear in MRI arthrography

Exclusion Criteria

* previous shoulder operations
* too high risk for operation
* any disease or social problem reducing the ability to co-operate
* rheumatoid arthritis
* severe arthrosis of the glenohumeral or acromioclavicular joint
* irreparable rotator cuff tear (including rotator cuff tear arthropathy)
* progressive malign disease
* adhesive capsulitis
* high-energy trauma before symptoms
* cervical syndrome
* shoulder instability
Minimum Eligible Age

35 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Academy of Finland

OTHER

Sponsor Role collaborator

Oulu University Hospital

OTHER

Sponsor Role collaborator

Central Finland Hospital District

OTHER

Sponsor Role lead

Responsible Party

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Juha Paloneva

Md, PhD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Juha Paloneva, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Central Finland Health Care District, University of Eastern Finland

Locations

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University of Helsinki

Helsinki, , Finland

Site Status

Central Finland Hospital

Jyväskylä, , Finland

Site Status

Oulu University Hospital

Oulu, , Finland

Site Status

Countries

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Finland

References

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Oh LS, Wolf BR, Hall MP, Levy BA, Marx RG. Indications for rotator cuff repair: a systematic review. Clin Orthop Relat Res. 2007 Feb;455:52-63. doi: 10.1097/BLO.0b013e31802fc175.

Reference Type BACKGROUND
PMID: 17179786 (View on PubMed)

Kukkonen J, Joukainen A, Lehtinen J, Mattila KT, Tuominen EK, Kauko T, Aarimaa V. Treatment of Nontraumatic Rotator Cuff Tears: A Randomized Controlled Trial with Two Years of Clinical and Imaging Follow-up. J Bone Joint Surg Am. 2015 Nov 4;97(21):1729-37. doi: 10.2106/JBJS.N.01051.

Reference Type BACKGROUND
PMID: 26537160 (View on PubMed)

Kukkonen J, Joukainen A, Lehtinen J, Mattila KT, Tuominen EK, Kauko T, Aarimaa V. Treatment of non-traumatic rotator cuff tears: A randomised controlled trial with one-year clinical results. Bone Joint J. 2014 Jan;96-B(1):75-81. doi: 10.1302/0301-620X.96B1.32168.

Reference Type BACKGROUND
PMID: 24395315 (View on PubMed)

Lambers Heerspink FO, van Raay JJ, Koorevaar RC, van Eerden PJ, Westerbeek RE, van 't Riet E, van den Akker-Scheek I, Diercks RL. Comparing surgical repair with conservative treatment for degenerative rotator cuff tears: a randomized controlled trial. J Shoulder Elbow Surg. 2015 Aug;24(8):1274-81. doi: 10.1016/j.jse.2015.05.040.

Reference Type BACKGROUND
PMID: 26189808 (View on PubMed)

Moosmayer S, Lund G, Seljom US, Haldorsen B, Svege IC, Hennig T, Pripp AH, Smith HJ. Tendon repair compared with physiotherapy in the treatment of rotator cuff tears: a randomized controlled study in 103 cases with a five-year follow-up. J Bone Joint Surg Am. 2014 Sep 17;96(18):1504-14. doi: 10.2106/JBJS.M.01393.

Reference Type BACKGROUND
PMID: 25232074 (View on PubMed)

Moosmayer S, Lund G, Seljom U, Svege I, Hennig T, Tariq R, Smith HJ. Comparison between surgery and physiotherapy in the treatment of small and medium-sized tears of the rotator cuff: A randomised controlled study of 103 patients with one-year follow-up. J Bone Joint Surg Br. 2010 Jan;92(1):83-91. doi: 10.1302/0301-620X.92B1.22609.

Reference Type BACKGROUND
PMID: 20044684 (View on PubMed)

Paloneva J, Lepola V, Aarimaa V, Joukainen A, Ylinen J, Mattila VM. Increasing incidence of rotator cuff repairs--A nationwide registry study in Finland. BMC Musculoskelet Disord. 2015 Aug 12;16:189. doi: 10.1186/s12891-015-0639-6.

Reference Type BACKGROUND
PMID: 26265152 (View on PubMed)

Paloneva J, Lepola V, Karppinen J, Ylinen J, Aarimaa V, Mattila VM. Declining incidence of acromioplasty in Finland. Acta Orthop. 2015 Apr;86(2):220-4. doi: 10.3109/17453674.2014.977703. Epub 2014 Oct 23.

Reference Type BACKGROUND
PMID: 25340548 (View on PubMed)

Cederqvist S, Flinkkila T, Sormaala M, Ylinen J, Kautiainen H, Irmola T, Lehtokangas H, Liukkonen J, Pamilo K, Ridanpaa T, Sirnio K, Leppilahti J, Kiviranta I, Paloneva J. Non-surgical and surgical treatments for rotator cuff disease: a pragmatic randomised clinical trial with 2-year follow-up after initial rehabilitation. Ann Rheum Dis. 2021 Jun;80(6):796-802. doi: 10.1136/annrheumdis-2020-219099. Epub 2020 Dec 3.

Reference Type DERIVED
PMID: 33272959 (View on PubMed)

Related Links

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http://www.ksshp.fi/musculoskeletalresearch

Clinical Musculoskeletal Diseases Research Group internet pages

Other Identifiers

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B07103-2

Identifier Type: -

Identifier Source: org_study_id

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