Arthroscopy-Assisted Lower Trapezius Transfer Using Long Head of Biceps Tendon Autograft as an Interposition Graft for Massive Irreparable Rotator Cuff Tears (LHBT)
The aim of the study is To evaluate the clinical, functional, and radiological outcomes of arthroscopically assisted lower trapezius tendon transfer using LHBT autograft as an interposition graft for massive irreparable rotator cuff tears., in terms of pain relief, shoulder range of motion, external rotation strength, patient-reported functional scores, and structural integrity of the transfer.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Massive rotator cuff tears represent a major cause of shoulder pain and disability among middle-aged and older patients. In younger, active patients with symptomatic massive irreparable tears, joint-preserving reconstructive procedures are generally favored over arthroplasty in order to maintain native anatomy and delay the need for prosthetic replacement. Tendon transfer of latissmus dorsi is preferered with autograft like Achillis tendon or semitendonosus tendon in this study we will use Long head of biceps tendon as interposition graft and evaluate the result clinicaly radiologicaly and functionaly postoperative
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Mahmoud M S Mahran, MD
- Phone Number: 00201018882565
- Email: mahmoudmahran408@gmail.com
Study Contact Backup
- Name: Esraa S Kotb, Master
- Phone Number: 01009595394
- Email: Esraasayed845@gmail.com
Study Locations
-
-
Asyut Governorate
-
Asyut, Asyut Governorate, Egypt, 71524
- Al-Azhar University Hospital, Assiut
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
- Older Adult
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria :
- symptomatic massive posterosuperior rotator cuff tear (involving ≥2 tendons and/or ≥5 cm in the anteroposterior dimension) confirmed by MRI
- Tear confirmed intraoperatively as irreparable despite maximal mobilization (medialized footprint repair not feasible)
- Intact or repairable subscapularis tendon
- Intact deltoid muscle function
- Failure of at least 3-6 months of conservative treatment (physiotherapy, analgesics, activity modification) or prior failed rotator cuff repair
- Preoperative active or passive forward elevation ≥ 0°-30° (i.e., not a pseudoparalytic shoulder with fixed loss of elevation, per surgeon's assessment) - to be defined per the surgical team's operative criteria
- Available and functioning lower trapezius muscle and long head of biceps tendon on preoperative examination/imaging
- Patient willing and able to comply with the postoperative rehabilitation protocol and scheduled follow-up visits
Exclusion criteria :
- Advanced glenohumeral osteoarthritis (Hamada grade ≥ 3)
- Irreparable subscapularis tear or anterosuperior tear pattern
- Deltoid dysfunction, paralysis, or previous deltoid detachment
- Lower trapezius dysfunction, atrophy, or prior denervation (e.g., spinal accessory nerve injury)
- Long head of biceps tendon absent, previously ruptured, or already tenotomized/tenodesed
- Axillary nerve palsy or brachial plexus injury
- Active glenohumeral or periprosthetic infection
- Uncontrolled systemic disease precluding surgery (e.g., uncontrolled diabetes mellitus, severe cardiopulmonary disease)
- Inflammatory arthropathy of the shoulder
- Previous ipsilateral shoulder arthroplasty
- Patients unable or unwilling to give informed consent or to comply with follow-up
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Long head of biceps tendon autograft
We asses the outcomes of Arthroscopy-Assisted Lower Trapezius Transfer Using Long Head of Biceps Tendon Autograft as an Interposition Graft for Massive Irreparable Rotator Cuff Tears |
Arthroscopy-Assisted Lower Trapezius Transfer Using Long Head of Biceps Tendon Autograft as an Interposition Graft for Massive Irreparable Rotator Cuff Tears |
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
change in Constant-Murley Shoulder Score
Time Frame: 6 weeks, 3, 6,9,months and 1 year
|
The Constant-Murley Shoulder Score (CMS) is a 100-point combined subjective and objective scoring system designed to assess overall shoulder function: Maximum Score: 100 points (indicates best possible shoulder function) Minimum Score: 0 points (indicates severe limitation/impairment) |
6 weeks, 3, 6,9,months and 1 year
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Visual analog score VAS
Time Frame: 6 weeks, 3, 6,9,months and 1 year
|
psychometric response scale used to measure subjective pain intensity, including shoulder pain: Standard Format: A 10 cm (100 mm) horizontal line anchored by two extreme descriptors at each end: 0 cm (0 mm): "No pain" 10 cm (100 mm): "Worst imaginable pain" (or "Worst pain ever felt") |
6 weeks, 3, 6,9,months and 1 year
|
Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
Other Study ID Numbers
- Azhar university Assiut
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Data will be available with a corresponding offer on reasonable request
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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