Tenotomy or Tenodesis of Long Head Biceps in Arthroscopic Rotator Cuff Repair

NCT ID: NCT02655848

Last Updated: 2019-10-01

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

98 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-07-31

Study Completion Date

2019-09-30

Brief Summary

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During arthroscopic rotator cuff (infraspinatus/supraspinatus) repair, biceps tendon lesions are frequently encountered. However, the most optimal treatment of the diseased long head of the biceps (LHB) tendon during rotator cuff repair remains a topic of debate: tenotomy or tenodesis. The hypothesis is that there is no difference in functional outcome between LHB tenotomy and LHB tenodesis when performed in adjunct to arthroscopic rotator cuff repair.

Detailed Description

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Patients older than 50 years with a supraspinatus and/or infraspinatus tendon rupture sized smaller than 3cm, who are encountered with LHB pathology, will be randomized to either LHB tenotomy or LHB tenodesis. Clinical and self-reported data will be collected pre-operatively, and 6 weeks, 3 months, and 1 year after surgery.

Primary outcome is overall shoulder function evaluated with the Constant score. As additional measures of shoulder function, the Dutch Oxford Shoulder Test and the Disabilities of the Arm Shoulder and Hand questionnaire will be assessed. Other evaluations include cosmetic appearance evaluated by the ''Popeye'' deformity, arm cramping pain, elbow flexion strength, MRI evaluation, quality of life, and cost of surgery. To detect non-inferiority with a one-sided, two-sample t-test with a 80% power and a significance level (alpha) of 0.025, the required sample size is 98 patients.

Conditions

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Rotator Cuff Syndrome

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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@ Cuff repair with LHB tenodesis

In case of pathologic changes of the long Head Biceps tendon, a tenodesis is performed in adjunct to performing an arthroscopic rotator cuff repair.

Group Type ACTIVE_COMPARATOR

Arthroscopic rotator cuff repair

Intervention Type PROCEDURE

Arthroscopic rotator cuff repair using suture anchors

LHB Tenodesis

Intervention Type PROCEDURE

Arthroscopic tenotomy and subsequent fixation of long head biceps proximal in the biceps groove

@ cuff repair with LHB tenotomy

In case of pathologic changes of the long Head Biceps tendon, a tenotomy is performed in adjunct to performing an arthroscopic rotator cuff repair.

Group Type ACTIVE_COMPARATOR

Arthroscopic rotator cuff repair

Intervention Type PROCEDURE

Arthroscopic rotator cuff repair using suture anchors

LHB Tenotomy

Intervention Type PROCEDURE

Arthroscopic tenotomy of long head biceps

Interventions

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Arthroscopic rotator cuff repair

Arthroscopic rotator cuff repair using suture anchors

Intervention Type PROCEDURE

LHB Tenodesis

Arthroscopic tenotomy and subsequent fixation of long head biceps proximal in the biceps groove

Intervention Type PROCEDURE

LHB Tenotomy

Arthroscopic tenotomy of long head biceps

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Patients older than 50 years
* Degenerative rotator cuff lesion of supraspinatus/infraspinatus tendon, smaller than three centimeter.
* Patients need to be able to read and write in Dutch or English language in order to complete the questionnaires, and sign informed consent.

Exclusion Criteria

* Acute, traumatic or partial thickness rotator cuff rupture, or in case a full thickness tear is larger than 3 cm measured using an arthroscopic ruler.
* Accompanying subscapularis tendon lesion
* Hour-glass deformation bicepstendon origin or in case of accompanying subscapularis tendon rupture.
* Osteoarthritis of the glenohumeral joint
* Acromion to humeral head distance measuring 6mm or smaller.
* Prior surgery to the involved shoulder
* Dementia or inability to complete questionnaires and assessments
Minimum Eligible Age

50 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Nederlandse Vereniging voor Arthroscopie

UNKNOWN

Sponsor Role collaborator

Smith & Nephew, Inc.

INDUSTRY

Sponsor Role collaborator

Onze Lieve Vrouwe Gasthuis

OTHER

Sponsor Role lead

Responsible Party

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DFP van Deurzen

Orthopedic Surgeon

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Derek van Deurzen, MD

Role: PRINCIPAL_INVESTIGATOR

OLVG

Locations

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Slootervaart ziekenhuis

Amsterdam, , Netherlands

Site Status

Kliniek De Lairesse

Amsterdam, , Netherlands

Site Status

OLVG

Amsterdam, , Netherlands

Site Status

Gelre ziekenhuis

Apeldoorn, , Netherlands

Site Status

Amphia ziekenhuis

Breda, , Netherlands

Site Status

Groene Hart Ziekenhuis

Gouda, , Netherlands

Site Status

Tergooi Ziekenhuizen

Hilversum, , Netherlands

Site Status

Spaarne Ziekenhuis

Hoofddorp, , Netherlands

Site Status

St Antonius

Nieuwegein, , Netherlands

Site Status

Canisius Wilehelmina Zkh

Nijmegen, , Netherlands

Site Status

Countries

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Netherlands

References

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Gurnani N, van Deurzen DF, Janmaat VT, van den Bekerom MP. Tenotomy or tenodesis for pathology of the long head of the biceps brachii: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc. 2016 Dec;24(12):3765-3771. doi: 10.1007/s00167-015-3640-6. Epub 2015 May 15.

Reference Type BACKGROUND
PMID: 25975753 (View on PubMed)

Zhang Q, Zhou J, Ge H, Cheng B. Tenotomy or tenodesis for long head biceps lesions in shoulders with reparable rotator cuff tears: a prospective randomised trial. Knee Surg Sports Traumatol Arthrosc. 2015 Feb;23(2):464-9. doi: 10.1007/s00167-013-2587-8. Epub 2013 Jul 5.

Reference Type BACKGROUND
PMID: 23828089 (View on PubMed)

Galasso O, Gasparini G, De Benedetto M, Familiari F, Castricini R. Tenotomy versus tenodesis in the treatment of the long head of biceps brachii tendon lesions. BMC Musculoskelet Disord. 2012 Oct 22;13:205. doi: 10.1186/1471-2474-13-205.

Reference Type BACKGROUND
PMID: 23088416 (View on PubMed)

van Deurzen DF, Scholtes VA, Willigenburg NW, Gurnani N, Verweij LP, van den Bekerom MP; BITE collaboration group. Long head BIceps TEnodesis or tenotomy in arthroscopic rotator cuff repair: BITE study protocol. BMC Musculoskelet Disord. 2016 Aug 30;17(1):375. doi: 10.1186/s12891-016-1230-5.

Reference Type DERIVED
PMID: 27577549 (View on PubMed)

Other Identifiers

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WO 10.087

Identifier Type: -

Identifier Source: org_study_id

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