- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04644042
The Effect of Arthroscopic Subacromial Decompression in Patients Who Are Non-responders to Non-operative Treatment. (SELECT)
The Effect of Arthroscopic Subacromial Decompression in Patients With Subacromial Impingement Syndrome Who Are Non-responders to Non-operative Treatment. A Double-blinded, Randomized, Controlled Trial.
Study Overview
Status
Conditions
Detailed Description
The trial is designed as a patient and assessor-blinded, randomized, controlled trial with two parallel groups. Participants are randomized 1:1 to either ASAD and glenohumeral arthroscopy (intervention group) or glenohumeral arthroscopy alone (control group). The two groups are subscribed identical postoperative rehabilitation consisting of 3 months physiotherapy in a municipally setting. The primary endpoint is the Shoulder Pain and Disability Index (SPADI) 12 months after surgical intervention. The study will adhere to the CONSORT guidelines.
All participants will be recruited consecutively from the outpatient clinic, Arthroscopic Center, Copenhagen University Hospital, Hvidovre. Consultant orthopedic surgeons will conduct the initial eligibility screening as part of their consultation. Eligible participants will be provided with thorough verbal and written information about the trial and their right to withdraw at any time. Patients given their written, informed consent to participate in the trial, will receive scheduled appointments for the baseline examination.
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Adam Witten, MD
- Phone Number: 004528780809
- Email: adam.witten.02@regionh.dk
Study Locations
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Hvidovre, Denmark, 2650
- Recruiting
- Hvidovre Univeristy Hospital
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Contact:
- Adam Witten, MD
- Phone Number: 28780809
- Email: adam.witten.02@regionh.dk
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- SIS diagnosis (Consultant's clinical diagnosis of SIS + at least 3 out of 5 positive tests from the following: Hawkin's, Neer's, Jobe's, Painful arc and external rotation resistance test)
- Positive subacromial injection test
- Insidious onset of shoulder pain
- Considered a surgical candidate by an orthopedic shoulder specialist.
- Symptoms for at least 6 months
- Completion of at least 3 months supervised shoulder training
- No improvement in symptoms for at least 3 months
- The patient must be expected to be able to attend rehabilitation and post-examinations.
Exclusion Criteria:
- Terminal illness or severe medical illness (ASA score higher than or equal to 4), systemic musculoskeletal disease, inflammatory joint disease (e.g. rheumatoid arthritis), symptomatic cervical spine pathology or thoracic outlet syndrome.
- Full-thickness rotator cuff tear, calcified tendonitis, labral tear, frozen shoulder, biceps tendon pathology, acromioclavicular osteoarthrosis, glenohumeral osteoarthrosis or other concomitant shoulder pathology.
- Previous surgery or radiotherapy on the affected shoulder.
- Pregnancy
- Ongoing workers compensation case or job rehabilitation process
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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Experimental: Glenohumeral arthroscopy and arthroscopic subacromial decompression
The intervention group will receive a glenohumeral arthroscopy and ASAD.
Participants are discharged with an arm sling and referred to 3 months physiotherapy in a municipally setting.
Participants are given a rehabilitation program containing progressive exercises to guide the rehabilitation.
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In addition to the glenohumeral athroscopy a lateral portal will be used to access the subacromial space.
The subacromial space will be decompressed with removal of inflamed bursal tissue and acromioclavicular osteophytes, release of the coracoacromial ligament, and, if deemed necessary by the surgeon, acromioplasty performed ad modum Caspari.
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Active Comparator: Glenohumeral arthroscopy and skin incision
The control group will receive a glenohumeral arthroscopy, but no treatment concerning the subacromial structures.
To allow for the best possible blinding, a 7-10 mm incision, mimicking the one used for ASAD, is performed on the lateral side of the arm 2-3 distal to the acromion.
Participants are discharged with an arm sling and referred to 3 months physiotherapy in a municipally setting.
Participants are given a rehabilitation program containing progressive exercises to guide the rehabilitation.
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Glenohumeral arthroscopy is performed as a standard investigational procedure.
The patient is put under general anesthesia and positioned in the 'beach chair position'.
An anteriorsuperior portal and a posterior mid-glenoid portal are used as entry to the joint.
The following structures are investigated as a minimum: the articular surface of the humeral head and the glenoid, labrum, the long biceps tendon and its attachment at the superior labrum, the undersurface of the supraspinatus and the infraspinatus tendon, the subscapularis tendon and the glenohumeral ligaments.
To allow for the best possible blinding a skin incision (mimicking the one used for arthroscopic subacromial decompression) is performed on the lateral side of the shoulder of the participants in the control group.
The obturator is introduced in the subcutaneous tissue and a slight circular release is performed.
The deltoid fascia is not perforated and the subacromial space is not entered.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Shoulder Pain and Disability Index (SPADI)
Time Frame: 12 months after surgical intervention.
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The primary outcome is SPADI 12 months after surgical intervention.
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12 months after surgical intervention.
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Shoulder Pain and Disability Index (SPADI)
Time Frame: 24 months
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SPADI is registered as a secondary outcome 3, 6 and 24 months after surgical intervention.
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24 months
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Oxford Shoulder Score
Time Frame: 24 months
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Oxford Shoulder Score is registered 3, 6, 12 and 24 months after surgical intervention.
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24 months
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Patient Satisfaction
Time Frame: 12 months
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Patient satisfaction will be assessed using three questions:
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12 months
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Active Shoulder Abduction Range Of Motion (AROM)
Time Frame: 12 months
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Active Shoulder Abduction Range Of Motion is registered at 3 and 12 months after surgical intervention.
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12 months
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Pain during Active Shoulder Abduction Range Of Motion (NPRS-AROM)
Time Frame: 12 months
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Pain during active shoulder abduction range of motion is evaluated using the numeric pain rating scale (NPRS) at 3 and 12 months after surgical intervention.
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12 months
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Collaborators and Investigators
Sponsor
Investigators
- Study Director: Kristoffer Barfod, MD, Sports Orthopedic Research Center - Copenhagen (SORC-C), Hvidovre Hospital
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- SELECT trial
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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