Suture Anchor Comparison in Rotator Cuff Repairs

TWO-ARM, SINGLE BLIND, RANDOMIZED POST-MARKET STUDY ON THE USE OF HEALICOIL™ REGENESORB SUTURE ANCHOR IN THE REPAIR OF TEARS OF THE ROTATOR CUFF

Patients will be randomized to receive HEALICOIL™ REGENESORB (the study anchor) or TWINFIX Ultra HA, a similar comparative product, for use in the repair of their shoulder injury. They will be asked to complete questionnaires throughout the study and will receive an MRI, CT and multiple ultrasound images. The MRIs and radiographs will be used to assess bony ingrowth at the repair site, and the ultrasound to assess repair success rate of the rotator cuff. The clinical and radiological outcomes will be compared between the study and control groups. It is hypothesized that there will be 85% high quality ossification at anchor site for HEALICOIL REGENESORB and 49.9% high quality ossification for TWINFIX Ultra HA at 24 months.

Study Overview

• Status: Completed
• Conditions: Rotator Cuff Injury
• Intervention / Treatment: Device: Suture Anchor HEALOCOIL; Device: Suture anchor Twinfix Ultra HA

• Study Type: Interventional
• Enrollment (Actual): 64
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • South Carolina
    • Greenville, South Carolina, United States, 29615
      • Steadman Hawkins Clinic of the Carolinas

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 35 years to 75 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Male or female, aged 35 to 75 years at the time of surgery.
• Willing and able to give voluntary informed consent to participate in this investigation.
• Full thickness tear of the rotator cuff
• Tear requires repair within one year 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 all required post-operative study visits.

Exclusion Criteria:

• 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.
• 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.
• 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 two years following surgery.
• Patient requires a concomitant SLAP repair procedure in operative shoulder.
• 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 Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: HEALICOIL Regenesorb; Suture anchor for rotator cuff repair	Device: Suture Anchor HEALOCOIL; Rotator cuff tears will be repaired intraoperatively using suture anchors
Active Comparator: Twinfix Ultra HA; Suture anchor for rotator cuff repair	Device: Suture anchor Twinfix Ultra HA

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Ossification Quality Score (Bony Ingrowth Assessed Via CT)	The ossification quality score is an ordinal measure of quality of bone reabsorption that is divided into four progressive groups. Quality score 1 reflects "little or no bone ossification", Quality score 2 reflects "Some ossification; discontinuous or with a wide lucent rim", Quality score 3 reflects "Ossification with a thin lucent rim", and Quality score 4 reflects "Good ossification; border of tract vague". For this study, Quality scores 1 and 2 will be merged (defined as low quality ossification) as will Quality scores 3 and 4 (defined as high quality ossification). The proportion of suture anchors graded as having high quality ossification versus low quality ossification will be compared between the two groups to determine if there is a significant difference between Healicoil and Twinfix anchors in regards to quality of ossification.	2 years

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of Participants With a Rotator Cuff Re-tear	Repair failure rate (Defined as number of subjects with a re-tear) determined by ultrasound 6 months after surgery.	6 months
Visual Analogue Pain Scale	The Visual Analogue Pain Scale (VAS) measures the patient-reported level of pain at the two-year follow-up. The scale runs from 0 to 10, with "0" indicating no pain and "10" indicating extreme pain. The lower the VAS Pain level, the better the outcome in regards to level of pain.	2 years
Function at Two Years as Measured by Western Ontario Rotator Cuff Index (WORC), PENN Shoulder Score (PENN), Single Assessment Numeric Evaluation (SANE), and EuroQol-5D (EQ-5D)	Outcomes at Two Years on the following: Western Ontario Rotator Cuff Index (WORC): developed to help understand the particular signs, symptoms, and functional limitations associated with rotator cuff tendinopathy. The outcome is measured on a scale of 0 to 100, with 100 being the best outcome and 0 being the worst.; PENN Shoulder Score (PENN): The PENN is a 100-point shoulder-specific self-report questionnaire evaluating pain, satisfaction, and shoulder function. The outcome is measured on a scale of 0 to 100, with 100 being the best outcome and 0 being the worst.; Single Assessment Numeric Evaluation (SANE): A single question that asks "How would you rate your shoulder today as a percentage of normal (0% to 100% scale with 100% being normal)?" 0 indicates an abnormal shoulder, whereas 100% indicates a perfectly normal shoulder.; Euroqol-5D (EQ-5D): The EQ-5D is a patient-reported overall health questionnaire, with 100 indicating "The best health you can imagine" and	2 years

Collaborators and Investigators

• Sponsor: The Hawkins Foundation
• Investigators: Principal Investigator: Stefan Tolan, MD, Steadman Hawkins Clinic of the Carolinas - Greenville Health System

Study record dates

Study Major Dates

• Study Start: May 1, 2014
• Primary Completion (Actual): March 1, 2019
• Study Completion (Actual): March 1, 2019

Study Registration Dates

• First Submitted: September 10, 2014
• First Submitted That Met QC Criteria: January 29, 2015
• First Posted (Estimate): January 30, 2015

Study Record Updates

• Last Update Posted (Actual): January 13, 2021
• Last Update Submitted That Met QC Criteria: January 11, 2021
• Last Verified: January 1, 2021

More Information

Terms related to this study

• Keywords: Ossification; Rotator cuff; Suture anchors
• Additional Relevant MeSH Terms: Wounds and Injuries; Rupture; Shoulder Injuries; Tendon Injuries; Rotator Cuff Injuries
• Other Study ID Numbers: Pro00031426