Allograft Reconstruction of Massive Rotator Cuff Tears vs Partial Repair Alone

NCT ID: NCT01987973

Last Updated: 2022-03-08

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

COMPLETED

Clinical Phase

NA

Total Enrollment

29 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-02-28

Study Completion Date

2021-03-31

Brief Summary

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The investigators hypothesize that the use of an allograft adjuvant to partial repair will lead to improved shoulder outcome measure scores compared to partial repair alone in massive rotator cuff tears.

Detailed Description

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A total of 30 patients will be enrolled in the study. Subjects will be randomized into two arms, either (1) Partial Repair/Debridement or (2) Allograft Reconstruction.

The patients will complete a structured clinical examination conducted by a sports medicine fellowship trained orthopaedic consultant, Pre-operatively and Post-operatively at 6 weeks, 3, 6, 12, 24 months. The examination will consist of range of motion testing by goniometer as well as strength testing by hand dynamometer. The patient will also complete the Western Ontario Rotator Cuff Index (WORC) questionnaire.

The main benefit of this procedure is that patients who have currently irreparable massive, chronic rotator cuff tears may acquire a means for their cuff to be repaired. This may aid in improving function of the shoulder, restoring ability to complete activities of daily living, while decreasing pain and sleep disturbances. This would allow the participant to become more functional after rehabilitation. It is our belief that this study could provide new information in helping to understand this relationship, which would in turn lead to future study in this area of orthopaedic surgery.

Conditions

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Rotator Cuff Syndrome Rotator Cuff Injury Disorder of Rotator Cuff Full Thickness Rotator Cuff Tear Skin Graft (Allograft) (Autograft) Failure

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Partial Repair / Debridement

Subjects in this arm of the study will receive the intervention "Partial Rotator Cuff Repair". This is the control group.

Group Type ACTIVE_COMPARATOR

Partial Rotator Cuff Repair

Intervention Type PROCEDURE

This is the control group. The bursa will be debrided thoroughly and rotator cuff edges will be shaved down to stable tissue. If possible, rip-stop sutures will be employed to stabilize the tear. The subacromial space will then be thoroughly irrigated.

Allograft Reconstruction

Subjects in this arm of the study will receive the intervention "Partial Rotator Cuff Repair with Allograft Augmentation"

Group Type EXPERIMENTAL

Partial Rotator Cuff Repair with Allograft Augmentation

Intervention Type PROCEDURE

Patients in this arm will undergo a partial rotator cuff repair (debridement), followed by an allograft augmentation. An Allopatch HD patch will be rehydrated in saline solution for 15 minutes. The patch is then sewn in place with braided polyester suture material. Multiple sutures, approximately 5 to 10 mm apart from one another will be used. The medial sutures are placed at least 3 cm medial to the tendon-bone attachment site. The patch is stretched to remove the manufacturing surface irregularities. The patch is then attached to the greater tuberosity at the tendon-bone attachment site with arthroscopic bone anchors. The subacromial space will then be thoroughly irrigated.

Interventions

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Partial Rotator Cuff Repair

This is the control group. The bursa will be debrided thoroughly and rotator cuff edges will be shaved down to stable tissue. If possible, rip-stop sutures will be employed to stabilize the tear. The subacromial space will then be thoroughly irrigated.

Intervention Type PROCEDURE

Partial Rotator Cuff Repair with Allograft Augmentation

Patients in this arm will undergo a partial rotator cuff repair (debridement), followed by an allograft augmentation. An Allopatch HD patch will be rehydrated in saline solution for 15 minutes. The patch is then sewn in place with braided polyester suture material. Multiple sutures, approximately 5 to 10 mm apart from one another will be used. The medial sutures are placed at least 3 cm medial to the tendon-bone attachment site. The patch is stretched to remove the manufacturing surface irregularities. The patch is then attached to the greater tuberosity at the tendon-bone attachment site with arthroscopic bone anchors. The subacromial space will then be thoroughly irrigated.

Intervention Type PROCEDURE

Other Intervention Names

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Debridement Human dermal allograft Allograft Reconstruction

Eligibility Criteria

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Inclusion Criteria

* Large/Massive rotator cuff tear \>3cm proven on MRI

Exclusion Criteria

* Non surgical candidate, unable to consent
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ivan Wong

OTHER

Sponsor Role lead

Responsible Party

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Ivan Wong

Orthopedic Surgeon

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Ivan H Wong, MD FRCS(C)

Role: PRINCIPAL_INVESTIGATOR

Nova Scotia Health Authority

Locations

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Nova Scotia Health Authority

Halifax, Nova Scotia, Canada

Site Status

Countries

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Canada

References

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Wong I, Sparavalo S, King JP, Coady CM. Bridging Allograft Reconstruction Is Superior to Maximal Repair for the Treatment of Chronic, Massive Rotator Cuff Tears: Results of a Prospective, Randomized Controlled Trial. Am J Sports Med. 2021 Oct;49(12):3173-3183. doi: 10.1177/03635465211039846. Epub 2021 Sep 8.

Reference Type DERIVED
PMID: 34494901 (View on PubMed)

Other Identifiers

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2014-182

Identifier Type: -

Identifier Source: org_study_id

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