Rotator Cuff Injury to Surgery (RC-IS)
Effect of Surgical Wait Times on Outcomes of Rotator Cuff Surgery
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
Consented patients will undergo a pre-operative assessment conducted by a study physiotherapist, including the following: 1) demographic information (age, gender, height, weight, smoking status, employment, recreational activities, time of injury, etc.); 2) shoulder ROM, 3) shoulder strength using a handheld dynamometer, and 4) subjective shoulder-specific outcome measures which include the Western Ontario Rotator Cuff Score (WORC), American Shoulder and Elbow Score (ASES), and Simple Shoulder Test (SST). Measurement of tear size will also be documented by an experienced radiologist from the initial MRI or ultrasound.
Patients will undergo initial consultation with the orthopaedic surgeon to confirm suitability for surgical management. If deemed appropriate to continue as a participant, the individual participants will be randomized to one of the two study groups. If in the Expedited group, the patient will proceed to have rotator cuff repair surgery within 3 months of the initial consult with the sports medicine physician. If randomized to the Control or 'Typical Wait Time' Group, surgery will take place no earlier than 9 months and no later than 12 months after the sports medicine physician consult.
Just prior to surgery, a second diagnostic imaging test will take place, either ultrasound or MRI, to document progress in tear size and any secondary pathology in the control group. Diagnostic test findings will be confirmed intraoperatively. All rotator cuff repairs will be performed by one of four fellowship trained orthopaedic surgeons.
The control study group will be sent the subjective questionnaires at 8 week intervals while they are waiting for surgery. Post-surgery study follow-ups will take place at 6, 12, and 24 months for both groups. All patients will be provided with the same rehabilitation protocol including pain management, range of motion and strengthening exercises. The same data as that collected pre-surgery will be repeated as well as any occurrences of failure of the repair. Failure of the repair is defined as ongoing severe pain, limited ROM, and/or decreased strength. If a failure occurs, follow-ups will continue until 24 months following failure or 24 months following revision surgery, if performed.
Undersøgelsestype
Undersøgelsestype
Fase
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiesteder
-
-
Manitoba
-
Winnipeg, Manitoba, Canada, R3M3E4
- Pan Am Clinic
-
-
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
- Between the ages of 45 and 70 years old
- Acute full-thickness rotator cuff tear of supraspinatus an/or infraspinatus (as confirmed by appropriate diagnostic imagine)
Exclusion Criteria:
- Presence of a tear of the subscapularis and/or teres minor;
- Presence of a partial-thickness tear of the supraspinatus/infraspinatus;
- Patient has undergone previous RC surgery to the affected shoulder;
- Patient has an active WCB Claim or prior claim related to their shoulder;
- Previous major joint trauma, infection, or avascular necrosis;
- Chronic dislocation, inflammation, or degenerative glenohumeral arthropathy;
- Evidence of significant cuff arthropathy (superior glenohumeral translation and/or acromial erosion, as diagnosed by diagnostic imaging)
- Psychiatric illness, cognitive impairment, or other health condition (i.e. visual impairment) which precludes informed consent or renders the patient unable to complete study questionnaires
- Major medical illness where life expectancy is less than 2 years;
- Does not speak/read/understand English;
- No fixed address or means of contact;
- Unwillingness to complete necessary follow-ups
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Enkelt gruppeopgave
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Aktiv komparator: Early Surgery
|
Patient will proceed to have rotator cuff repair surgery within 3 months of the initial consult with the sport medicine physician.
|
|
Eksperimentel: Regular Wait Time
|
Surgery will take place no earlier than 9 months and no later than 12 months after the sport medicine physician consult.
|
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Western Ontario Rotator Cuff
Tidsramme: 24 months
|
WORC score questionnaire is a tool designed for self-assessment of shoulder function for patients with rotator cuff problems.
Difference between study arm outcomes will be assessed using pre-op WOSI score as a covariate
|
24 months
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
American Shoulder and Elbow Surgeons (ASES)
Tidsramme: 24 months
|
The ASES assessment (patient report section) is a region-specific questionnaire designed for self-assessment of aspects of pain and function.
Difference between study arm outcomes will be assessed using pre-op ASES score as a covariate
|
24 months
|
Andre resultatmål
Andre resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Injury to Surgery Time
Tidsramme: 24 months
|
Time will be calculated from initial injury to consultation to surgery.
|
24 months
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Efterforskere
Efterforskere
- Ledende efterforsker: Jeff Leiter, MSc, PhD, Pan Am Clinic
Datoer for undersøgelser
Studer store datoer
Studiestart
Studiestart
Primær færdiggørelse (Forventet)
Primær færdiggørelse
Studieafslutning (Forventet)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Skøn)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- B2012:112
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