Operative Versus Non-Operative Treatment for Atraumatic Rotator Cuff Tears

NCT ID: NCT03295994

Last Updated: 2025-03-30

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

189 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-03-19

Study Completion Date

2025-02-28

Brief Summary

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Rotator cuff tears are one of the most common reasons to seek musculoskeletal care in the United States and one of the fastest growing ambulatory surgery procedures. However, data on comparison of operative versus non-operative treatment is lacking and urgently needed.

Detailed Description

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This is non-blinded, randomized controlled trial. Patients will be randomly assigned to either an operative or non-operative course of treatment and will be followed for 12 months from baseline.

Aim 1: To compare pain and function in patients undergoing operative versus non-operative treatment of atraumatic rotator cuff tears at 12 months of follow-up

Aim 2: To assess effects of rotator cuff tear size and age on comparative outcomes of operative versus non-operative treatments for atraumatic rotator cuff tears

5U34AR069201-02 NIH grant funded the preparatory work for the trial but not the trial itself.

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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Operative

surgery + post-operative physical therapy

Group Type ACTIVE_COMPARATOR

Operative

Intervention Type PROCEDURE

Arthroscopic rotator cuff surgery followed by physical therapy.

Non-Operative

non-operative physical therapy

Group Type ACTIVE_COMPARATOR

Non-Operative

Intervention Type PROCEDURE

Physical therapy (without surgery).

Interventions

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Operative

Arthroscopic rotator cuff surgery followed by physical therapy.

Intervention Type PROCEDURE

Non-Operative

Physical therapy (without surgery).

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Aged =\>40 years to \<85 years
* Shoulder pain and/or loss of range of active motion, strength or function
* MRI-confirmed partial- or full-thickness supraspinatus and/or infraspinatus tear of 4cm or less in longitudinal dimension
* Medically fit for surgery, defined as Category I-III per American Society of Anesthesiologists (ASA) Physical Status Classification
* Ability and willingness to provide informed consent

Exclusion Criteria

* Primary diagnosis is something other than a rotator cuff tear
* History (in last 2 years) of shoulder fracture involving the humeral head on affected side
* Previous rotator cuff surgery on affected side
* Isolated subscapularis \&/or teres minor tear on affected side
* Acute rotator cuff tear caused by a severe trauma
* Shoulder used as a weight-bearing joint
* Contraindication to MRI (claustrophobia, pacemaker, pregnancy, shoulder implant, etc.)
* Glenohumeral osteoarthritis on xrays/MRI, as determined by recruiting MD
* Grade 4 fatty infiltration of rotator cuff (any tendons)
* Candidate for shoulder arthroplasty at baseline
* Non-English speaking
Minimum Eligible Age

40 Years

Maximum Eligible Age

84 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Patient-Centered Outcomes Research Institute

OTHER

Sponsor Role collaborator

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)

NIH

Sponsor Role collaborator

University of Michigan

OTHER

Sponsor Role lead

Responsible Party

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Nitin Jain

Professor of Physical Medicine & Rehabilitation, and Orthopaedics

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Nitin Jain, MD,MSPH

Role: PRINCIPAL_INVESTIGATOR

University of Michigan

Locations

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University of California - San Francisco (UCSF)

San Francisco, California, United States

Site Status

Western Orthopaedics

Denver, Colorado, United States

Site Status

University of Colorado - Denver

Denver, Colorado, United States

Site Status

University of Iowa

Iowa City, Iowa, United States

Site Status

University of Kentucky

Lexington, Kentucky, United States

Site Status

Johns Hopkins

Baltimore, Maryland, United States

Site Status

Boston Medical Center

Boston, Massachusetts, United States

Site Status

Beth Israel Deaconess Medical Center

Boston, Massachusetts, United States

Site Status

University of Michigan

Ann Arbor, Michigan, United States

Site Status

Washington University

St Louis, Missouri, United States

Site Status

The Ohio State University Wexner Medical Center

Columbus, Ohio, United States

Site Status

University of Pennsylvania

Philadelphia, Pennsylvania, United States

Site Status

Rothman Orthopaedic Institute

Philadelphia, Pennsylvania, United States

Site Status

Medical University of South Carolina

Charleston, South Carolina, United States

Site Status

Orthopedic Institute

Sioux Falls, South Dakota, United States

Site Status

Ortho Tennessee - Knoxville Orthopedic Clinic

Knoxville, Tennessee, United States

Site Status

Vanderbilt University Medical Center

Nashville, Tennessee, United States

Site Status

University of Texas Southwestern

Dallas, Texas, United States

Site Status

Ortho Virginia

Richmond, Virginia, United States

Site Status

Countries

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United States

References

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Jain NB, Ayers GD, Koudelkova H, Archer KR, Dickinson R, Richardson B, Derryberry M, Kuhn JE; ARC Trial Group. Operative vs Nonoperative Treatment for Atraumatic Rotator Cuff Tears: A Trial Protocol for the Arthroscopic Rotator Cuff Pragmatic Randomized Clinical Trial. JAMA Netw Open. 2019 Aug 2;2(8):e199050. doi: 10.1001/jamanetworkopen.2019.9050.

Reference Type DERIVED
PMID: 31397866 (View on PubMed)

Related Links

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Other Identifiers

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1605-35413

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

171863

Identifier Type: -

Identifier Source: org_study_id

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