Biomarkers for the Surgical Treatment of Rotator Cuff Tears (MARK-GEROT)

Identification of biomarkers that can predict the outcome of the surgical treatment (i.e. the rate of re-rupture) of tears in the rotator cuff tendon.

Study Overview

• Status: Unknown
• Conditions: Rotator Cuff Tears

Detailed Description

Rotator cuff tears (i.e. structural failure and tissue disruption in at least one of the four muscles and tendons that form the rotator cuff) are extremely common injuries and represent the most common muscle-tendon tear in patients. Repair of rotator cuff tears is usually advocated for painful tears with functional impairment. However, high failure rates of 13-68% have been reported for surgical repair of rotator cuff tears, irrespective of the surgical technique employed. Higher rates of re-rupture are associated with larger tears, increased patient age, and increased fatty degeneration of the cuff muscles. There is no general consensus as to the causes of re-rupture; where mechanical factors, the existing techniques of suturing, and biological factors are considered as the main factors of recurrence.

• Study Type: Observational
• Enrollment (Anticipated): 100

Contacts and Locations

Study Locations

• Switzerland
  • Zurich, Switzerland, 8008
    • Recruiting
    • Balgrist University Hospital
    • Contact: Martin Flück, PhD; Phone Number: 3791 +41 44 386; Email: mflueck@research.balgrist.ch
    • Contact: Marco Toigo, PhD; Phone Number: 3794 +41 44 386; Email: mtoigo@research.balgrist.ch
    • Principal Investigator: Christian Gerber, MD FRCS(Ed)
    • Sub-Investigator: Dominik Meyer, MD
    • Sub-Investigator: Karl Wieser, MD
    • Principal Investigator: Martin Flück, PhD

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 40 years to 80 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Regular patients from Balgrist University Hospital, Zurich (Switzerland)

Description

Inclusion Criteria:

• Full-thickness rotator cuff tear (isolated transmural supraspinatus muscle tear or combined with infraspinatus and subscapularis tears) with fat content <50% (Goutallier stage 0-2), as confirmed by magnetic resonance imaging
• Acute or chronic ruptures
• Older than 40 years of age
• Voluntary participation in this study
• Written informed consent to participate in this study

Exclusion Criteria:

• Contraindication because of ethical reasons
• Pregnant or lactating women
• Intention/wish to become pregnant during the course of this study
• Unsafe contraception
• Clinical co-morbidities, such as renal insufficiency, hepatic dysfunction, cardiovascular disease
• Known or suspected non-adherence to the study protocol
• Smoker
• Drug or alcohol addicted
• Uncapable of following instructions, e.g. because of insufficient proficiency in languages, psychological problems, dementia, etc.
• Participation in other clinical trials during the duration of this study, as well as 30 d before inclusion in this study
• Claustrophobia
• Systemic corticoid steroid therapy

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
Rotator cuff tear; Patients which demonstrate a full-thickness tear of the rotator cuff tendon and meet the inclusion criteria.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Changes from baseline for anatomical and functional characteristics of the ruptured rotator cuff	Patients will undergo a clinical and functional examination which includes the assessment of mobility, pain and abduction force of the affected and healthy shoulder using standardized tests (Constant score, Quick DASH, Quality of Life Score SF-12), the quantification of the volume (cm3) and fat content (Goutallier Stage) of the affected shoulder using magnet resonance imaging.	Before surgery (baseline), 3 months after surgery, 12 months after surgery
Molecular and cellular characteristics of the tissues affected by tears of the rotator cuff	Before the surgery 10 mL of venous blood will be drawn from the patients and processed for the isolation of genomic DNA and the measure of selected single nuclear polymorphisms. Biopsies (~10 mg) will be collected intra-operatively from the affected muscle, tendon, capsule and synovial liquid and stored at -80°C. Samples will be subjected to the immunohistochemical and biochemical quantification of the content (in arbitrary units) of selected proteins and tissue composition (as % of total volume).	within 1 year after the last surgery

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Correlation between the molecular and cellular characteristics at the point in time of surgery, and the clinical (magnetic resonance imaging) outcomes	The relationship of the molecular and cellular parameters (measured as primary endpoints) of affected muscle with the clinical and functional measures of shoulder function will be investigated using Pearson correlation and mutual information analysis.	within 1 year after the last surgery

Collaborators and Investigators

• Sponsor: Balgrist University Hospital
• Collaborators: RESORTHO foundation, Forchstrasse 340, 8008 Zürich, Switzerland

Study record dates

Study Major Dates

• Study Start: April 1, 2014
• Primary Completion (Anticipated): June 1, 2017
• Study Completion (Anticipated): December 1, 2017

Study Registration Dates

• First Submitted: April 14, 2014
• First Submitted That Met QC Criteria: April 24, 2014
• First Posted (Estimate): April 28, 2014

Study Record Updates

• Last Update Posted (Estimate): July 4, 2016
• Last Update Submitted That Met QC Criteria: July 1, 2016
• Last Verified: July 1, 2016

More Information

Terms related to this study

• Keywords: Biomarker; Predictive factors; Rotator Cuff Tear; Skeletal Muscle; Rotator Cuff Repair; Tendon; Subacromial Bursa
• Additional Relevant MeSH Terms: Wounds and Injuries; Rupture; Shoulder Injuries; Tendon Injuries; Rotator Cuff Injuries
• Other Study ID Numbers: W 522 MARK GEROT; KEK-ZH-Nr. 2013-0352 (Other Identifier: Ethics Committee of the Canton Zurich, Switzerland)