Study of Personalized Instrument in Total Shoulder Arthroplasty The P.I.T.S.A. Study

NCT ID: NCT03839758

Last Updated: 2025-09-22

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

RECRUITING

Clinical Phase

NA

Total Enrollment

112 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-10-08

Study Completion Date

2028-12-31

Brief Summary

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Total shoulder arthroplasty is an effective procedure to improve patients function and to relieve shoulder pain in cases of glenohumeral arthritis. The main challenge of this procedure is implanting the glenoid component. Indeed, surgical exposure is difficult and proper visualization of the glenoid is demanding. The current free-hand method is not precise and especially unreliable in glenoids with severe deformity. Inappropriate reaming and glenoid positioning can cause more bone loss during surgery.

In anatomic prostheses, glenoid component fixation is demanding and is the first component to present loosening at long term follow-up. When it comes to reverse arthroplasty, the glenoid component, once again, requires the most attention. Malpositioning of the glenosphere can cause notching, loosening, and instability.

In order to prevent these complications, precision in glenoid implantation is key. To this end, intraoperative computer navigation would be a helpful tool, but the increased expenses in computer equipment represent massive costs and possibly increases in surgical time. A more affordable option is a personalized guide, for which the only extra expense is the customized guide. These guides are based on precise 3D CT scan templates. Previous studies have evaluated the precision of the guide in vivo and in vitro, but none have measured it in a randomized study. As it represents additional costs, its efficacy needs to be proven before widespread use.

This method may also provide secondary benefits, such as decreasing operating time, lowering short- and long-term complications, and improving efficacy.

The objective of this study is to evaluate the performance of a patient specific glenoid guide.

Detailed Description

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All participants scheduled for elective primary total shoulder arthroplasty will be contacted by a research assistant. Preoperative status will be characterized by demographic data, range of motion, quality of life, and functional status. A CT Scan and x-rays are part of standard preoperative care and always done prior to total shoulder replacement in our institution; these images will be collected for the study. Patients will be randomized to one of the two groups:

1. Patient-specific glenoid guide group: Glenoid preparation will be done using the personalized guide provided by Wright-Tornier. This guide will be ordered after CT-scan measurement, using Blueprint software prior to surgery.
2. Classic method group: Glenoid preparation will be done following surgeon evaluation of the 2D CT scan with the institution software. Generic guides included in the regular instrumentation set will be used.

The investigators will use the classification proposed by Iannotti et al. to characterize glenoid bone loss prior to surgery. Glenoid bone density will be measured using radiology software (Hounsfield units). Blueprint software will be used to measure the preoperative anatomical characteristics of the glenoid: surface area, version, inclination and subluxation. This will be done prior to surgery in the patient specific group and after surgery in the classic group.

Conditions

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Shoulder Arthritis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors
The evaluator who will perform the follow-up clinical examination will also be blind

Study Groups

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TSA Standard

This group will include patients schedule for a total shoulder arthroplasty. Glenoid preparation will be done following surgeon evaluation of the 2D CT scan with the institution software. Generic guides included in the regular instrumentation set will be used

Group Type ACTIVE_COMPARATOR

TSA standard

Intervention Type PROCEDURE

Glenoid preparation will be done with 2D CT-Scan

RTSA standard

This group will include patients schedule for a reverse total shoulder arthroplasty. Glenoid preparation will be done following surgeon evaluation of the 2D CT scan with the institution software. Generic guides included in the regular instrumentation set will be used

Group Type ACTIVE_COMPARATOR

RTSA standard

Intervention Type PROCEDURE

Glenoid preparation will be done with 2D CT-Scan

TSA blueprint

This group will include patients schedule for a total shoulder arthroplasty. Glenoid preparation will be done using the personalized guide provided by Wright-Tornier. This guide will be ordered after CT-scan measurement, using Blueprint software prior to surgery.

Group Type EXPERIMENTAL

TSA Blueprint

Intervention Type PROCEDURE

Glenoid preparation will be done with Blueprint software

RTSA blueprint

This group will include patients schedule for a reverse total shoulder arthroplasty. Glenoid preparation will be done using the personalized guide provided by Wright-Tornier. This guide will be ordered after CT-scan measurement, using Blueprint software prior to surgery.

Group Type EXPERIMENTAL

RTSA Blueprint

Intervention Type PROCEDURE

Glenoid preparation will be done with 2D CT-Scan

Interventions

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TSA standard

Glenoid preparation will be done with 2D CT-Scan

Intervention Type PROCEDURE

RTSA standard

Glenoid preparation will be done with 2D CT-Scan

Intervention Type PROCEDURE

TSA Blueprint

Glenoid preparation will be done with Blueprint software

Intervention Type PROCEDURE

RTSA Blueprint

Glenoid preparation will be done with 2D CT-Scan

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Patients with shoulder osteaoarthritis and AVN

Exclusion Criteria

* Patients with previous shoulder arthroplasty
* Patients with inflammatory arthritis and tumor
* Patients with previous shoulder surgery with metal implant
* Patients refusing 2-year follow-up
* Patients that does not speak English or French
* Patients with current or previous shoulder infection
* Patients with graft during surgery
Minimum Eligible Age

18 Years

Maximum Eligible Age

99 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Université de Montréal

OTHER

Sponsor Role lead

Responsible Party

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Dominique Rouleau

Orthopaedic surgeon

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Dominique Rouleau, MD

Role: PRINCIPAL_INVESTIGATOR

Université de Montréal

Locations

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Hôpital du Sacré-Cœur de Montréal

Montreal, Quebec, Canada

Site Status RECRUITING

Countries

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Canada

Central Contacts

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Dominique Rouleau, MD

Role: CONTACT

514-338-2222 ext. 2050

Karine Tardif

Role: CONTACT

514-338-2222 ext. 3464

Facility Contacts

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Dominique Rouleau

Role: primary

514-338-2222 ext. 2050

Karine Tardif

Role: backup

514-338-2222 ext. 3465

Other Identifiers

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PITSA

Identifier Type: -

Identifier Source: org_study_id

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