Pilot Study of the Use of ULTRABRAID PLUS SUTURE in the Repair of Tears of the Rotator Cuff

Two-Arm, Single Blind, Randomized Pilot Study on the Use of ULTRABRAID PLUS SUTURE in the Repair of Tears of the Rotator Cuff

The primary objective of this study is to obtain safety data on the use of the ULTRABRAID PLUS SUTURE, and to assess the preliminary effectiveness of the use of the ULTRABRAID PLUS SUTURE in comparison to the ULTRABRAID SUTURE in patients undergoing rotator cuff repair.

Study Overview

• Status: Completed
• Conditions: Rotator Cuff Tear
• Intervention / Treatment: Device: ULTRABRAID PLUS SUTURE; Device: ULTRABRAID SUTURE

Detailed Description

The primary objective of this two-arm, randomized, single-blind pilot study is to obtain safety data on the use of the ULTRABRAID Plus Suture and to assess the preliminary effectiveness of the use of the ULTRABRAID Plus Suture in comparison to the ULTRABRAID Suture in subjects undergoing rotator cuff repair. The primary endpoint of the 6-month postoperative analysis is to assess rotator cuff integrity at 6 months, defined as the proportion of subjects with a re-tear of the rotator cuff as measured by high-resolution ultrasound.

Secondary endpoints include:

rotator cuff integrity at the other time points, as well as between arms (1, 3, 6 weeks and 3, 12 months); difference in tissue thickness and muscle atrophy using high-resolution ultrasound between baseline (preoperative) and all postoperative time points (1, 3, 6 weeks and 3, 6, 12 months); difference in tendon echogenicity and vascularity using Doppler ultrasound between baseline (preoperative) and all postoperative time points (1, 3, 6 weeks and 3, 6, 12 months); difference in Constant Shoulder Assessment score and Western Ontario Rotator Cuff (WORC) Index between baseline (preoperative) and all postoperative time points (1, 3, 6 weeks and 3, 6, 12 months); rehabilitation:

• time to active-assisted rehab exercises
• time to isometric rehab exercises
• time to discontinuation of an arm sling lab results (C-Reactive Protein [CRP], Erythrocyte Sedimentation Rate [ESR] and Butyric Acid Levels) at 1, 3, and 6 weeks postoperatively; adverse event (AE) rates (all categories).

• Study Type: Interventional
• Enrollment (Actual): 82
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Canada
  • Ontario
    • Burlington, Ontario, Canada, L7R 4C7
      • Innovation Science and Medicine
    • London, Ontario, Canada, N6A 3K7
      • Fowler Kennedy Sport Medicine Clinic
    • London, Ontario, Canada, N6A 4L6
      • St. Josephs Hospital
    • Toronto, Ontario, Canada, M5C 1R6
      • Women's College Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 70 years (ADULT, OLDER_ADULT)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria (Subjects must meet ALL of the following criteria):

• Male or female, aged 18 to 70 years at the time of surgery
• Willing and able to give voluntary informed consent to participate in this investigation
• Small (<1cm), Medium (1-3cm) or large (>3-5cm) tear of the supraspinatus tendon, which may or may not include the infraspinatus tendon of the rotator cuff. Tear size will be based on area of longest dimension as evidenced by clinical examination and diagnostic imaging prior to surgery, with the definitive measurement confirmed at surgery
• Tear requires repair within two years of initial diagnosis
• Tear must be anatomically repairable (must be able to get tendon back to the medial position on the footprint and at least back to the tuberosity)
• Willing and able, in the opinion of the Investigator, to cooperate with study procedures, and willing to return to study site for physical therapy and all post-operative study visits

Exclusion Criteria (Subjects must not meet ANY of the following criteria):

• Tears involving tendons other than the supraspinatus and infraspinatus
• Partial thickness tears of the rotator cuff (tear must be full thickness)
• Evidence of acute trauma including fracture or dislocation of the shoulder joint
• Chronic retraction
• Evidence of active infection, osteomyelitis, sepsis or distant infection which could spread to the index joint
• Subject has had previous rotator cuff, arthroplasty or fracture procedures on the operative shoulder
• Subject has had acromioplasty or diagnostic arthroscopy on the operative shoulder within one (1) year prior to scheduled surgery date
• Evidence of osteomalacia or other metabolic bone disorder(s) which may impair bone or soft tissue function
• Evidence of other significant shoulder pathology including (Type II-IV lesion, Bankart lesion, Hill Sachs lesion)
• Patient has grade 4 changes to articular cartilage in operative shoulder
• Inflammatory arthropathies
• Significant muscle paralysis of the shoulder girdle.
• Painful pathologies of the cervical spine
• Comminuted bone surface, which would compromise secure anchor fixation.
• Subject has a known sensitivity to implant materials, including sodium butyrate.
• Non-surgical rotator cuff associated treatment, such as corticosteroid injection, within one (1) month prior to scheduled surgery date
• Participating in another investigational trial or ongoing study that would interfere with the assessment of the primary and secondary outcomes
• Female patient who is pregnant, nursing, or of childbearing potential while not practicing effective contraceptive methods
• Currently known to abuse drugs or alcohol which could affect follow-up care or treatment outcomes
• Current smoker
• Major psychiatric illness, developmental handicap or inability to read and understand the English language
• Major medical illness that would preclude undergoing surgery
• Known to be involved in any active injury litigation claims relating to the study shoulder
• Unwilling or unable to be assessed according to study protocol for one year following surgery
• Patient requires a concomitant SLAP repair procedure in operative shoulder
• Surgeon plans to use transosseous sutures in the study procedure
• Surgeon plans to use a Platelet Rich Plasma product or another therapy intended to augment healing of the rotator cuff in the study procedure
• Protocol specified surgical technique cannot be followed for this subject
• Rotator cuff repair will be done via open (as opposed to arthroscopic) procedure
• Any other reason (in the judgment of the investigator)

Study Plan

How is the study designed?

Design Details

• Primary Purpose: TREATMENT
• Allocation: RANDOMIZED
• Interventional Model: PARALLEL
• Masking: SINGLE

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
EXPERIMENTAL: ULTRABRAID PLUS SUTURE; ULTRABRAID Plus Suture manufactured by Smith & Nephew used in subjects undergoing rotator cuff repair.	Device: ULTRABRAID PLUS SUTURE; Rotator Cuff Repair with ULTRABRAID PLUS SUTURE
ACTIVE_COMPARATOR: ULTRABRAID SUTURE; ULTRABRAID Suture is a marketed suture manufactured by Smith & Nephew used in subjects undergoing rotator cuff repair.	Device: ULTRABRAID SUTURE; Rotator Cuff Repair with ULTRABRAID SUTURE

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Rotator Cuff Integrity	The primary endpoint of the 6-month postoperative analysis is to assess rotator cuff integrity at 6 months, defined as the proportion of subjects with a re-tear of the rotator cuff as measured by high-resolution ultrasound.	6 months post-operatively

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Rotator Cuff Integrity	To assess rotator cuff integrity defined as the proportion of subjects with a re-tear of the rotator cuff as measured by high-resolution ultrasound.	1, 3 and 6 weeks and 3 and 12 months post-operatively
Change in post-surgery tissue thickness, rotator cuff integrity, tendon echogenicity and muscle atrophy	Compared to Baseline (preop)	1, 3 and 6 weeks and 3, 6 and 12 months post-operatively
Change in Vascularity	Compared to Baseline (preop)	1, 3 and 6 weeks and 3, 6 and 12 months post-operatively
Change in Constant Shoulder Assessment	Compared to Baseline (preop)	1, 3 and 6 weeks and 3, 6 and 12 months post-operatively
Change in Western Ontario Rotator Cuff Index	Compared to Baseline (preop)	1, 3 and 6 weeks and 3, 6 and 12 months post-operatively
Rehabilitation	Time to active-assisted rehab exercises; Time to isometric rehab exercises; Time to discontinuation of arm sling	3 and 6 weeks and 3, 6 and 12 months post-operatively
Labs	Compared to Baseline (preop) Note: If levels do not return to baseline, tests will continue beyond 6 weeks	1, 3 and 6 weeks (optional 3, 6 and 12 months) post-operatively
Adverse Events	All AE measured and observed, from the initiation of the surgical procedure and throughout the subjects participation in the study, were recorded.	Surgery and 1, 3 and 6 weeks and 3, 6 and 12 months post-operatively

Collaborators and Investigators

• Sponsor: Smith & Nephew, Inc.
• Investigators: Principal Investigator: Robert Litchfield, MD, FRCSC, Fowler Kennedy Sports Medicine Clinic

Study record dates

Study Major Dates

• Study Start: February 1, 2013
• Primary Completion (ACTUAL): November 1, 2016
• Study Completion (ACTUAL): November 1, 2016

Study Registration Dates

• First Submitted: January 9, 2013
• First Submitted That Met QC Criteria: January 10, 2013
• First Posted (ESTIMATE): January 14, 2013

Study Record Updates

• Last Update Posted (ACTUAL): October 6, 2017
• Last Update Submitted That Met QC Criteria: October 4, 2017
• Last Verified: October 1, 2017

More Information

Terms related to this study

• Keywords: Rotator Cuff Tear; Supraspinatus Tear
• Additional Relevant MeSH Terms: Wounds and Injuries; Rupture; Shoulder Injuries; Tendon Injuries; Rotator Cuff Injuries
• Other Study ID Numbers: 15001105