Arthroscopy-Assisted Lower Trapezius Transfer Using Long Head of Biceps Tendon Autograft as an Interposition Graft for Massive Irreparable Rotator Cuff Tears (LHBT)
The aim of the study is To evaluate the clinical, functional, and radiological outcomes of arthroscopically assisted lower trapezius tendon transfer using LHBT autograft as an interposition graft for massive irreparable rotator cuff tears., in terms of pain relief, shoulder range of motion, external rotation strength, patient-reported functional scores, and structural integrity of the transfer.
Studieöversikt
Status
Betingelser
Detaljerad beskrivning
Massive rotator cuff tears represent a major cause of shoulder pain and disability among middle-aged and older patients. In younger, active patients with symptomatic massive irreparable tears, joint-preserving reconstructive procedures are generally favored over arthroplasty in order to maintain native anatomy and delay the need for prosthetic replacement. Tendon transfer of latissmus dorsi is preferered with autograft like Achillis tendon or semitendonosus tendon in this study we will use Long head of biceps tendon as interposition graft and evaluate the result clinicaly radiologicaly and functionaly postoperative
Studietyp
Inskrivning (Beräknad)
Fas
- Inte tillämpbar
Kontakter och platser
Studiekontakt
- Namn: Mahmoud M S Mahran, MD
- Telefonnummer: 00201018882565
- E-post: mahmoudmahran408@gmail.com
Studera Kontakt Backup
- Namn: Esraa S Kotb, Master
- Telefonnummer: 01009595394
- E-post: Esraasayed845@gmail.com
Studieorter
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Asyut Governorate
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Asyut, Asyut Governorate, Egypten, 71524
- Al-Azhar University Hospital, Assiut
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Deltagandekriterier
Urvalskriterier
Åldrar som är berättigade till studier
- Barn
- Vuxen
- Äldre vuxen
Tar emot friska volontärer
Kön som är behöriga för studier
Beskrivning
Inclusion Criteria :
- symptomatic massive posterosuperior rotator cuff tear (involving ≥2 tendons and/or ≥5 cm in the anteroposterior dimension) confirmed by MRI
- Tear confirmed intraoperatively as irreparable despite maximal mobilization (medialized footprint repair not feasible)
- Intact or repairable subscapularis tendon
- Intact deltoid muscle function
- Failure of at least 3-6 months of conservative treatment (physiotherapy, analgesics, activity modification) or prior failed rotator cuff repair
- Preoperative active or passive forward elevation ≥ 0°-30° (i.e., not a pseudoparalytic shoulder with fixed loss of elevation, per surgeon's assessment) - to be defined per the surgical team's operative criteria
- Available and functioning lower trapezius muscle and long head of biceps tendon on preoperative examination/imaging
- Patient willing and able to comply with the postoperative rehabilitation protocol and scheduled follow-up visits
Exclusion criteria :
- Advanced glenohumeral osteoarthritis (Hamada grade ≥ 3)
- Irreparable subscapularis tear or anterosuperior tear pattern
- Deltoid dysfunction, paralysis, or previous deltoid detachment
- Lower trapezius dysfunction, atrophy, or prior denervation (e.g., spinal accessory nerve injury)
- Long head of biceps tendon absent, previously ruptured, or already tenotomized/tenodesed
- Axillary nerve palsy or brachial plexus injury
- Active glenohumeral or periprosthetic infection
- Uncontrolled systemic disease precluding surgery (e.g., uncontrolled diabetes mellitus, severe cardiopulmonary disease)
- Inflammatory arthropathy of the shoulder
- Previous ipsilateral shoulder arthroplasty
- Patients unable or unwilling to give informed consent or to comply with follow-up
Studieplan
Hur är studien utformad?
Designdetaljer
- Primärt syfte: Behandling
- Tilldelning: N/A
- Interventionsmodell: Enskild gruppuppgift
- Maskning: Ingen (Open Label)
Vapen och interventioner
Deltagargrupp / Arm |
Intervention / Behandling |
|---|---|
|
Experimentell: Long head of biceps tendon autograft
We asses the outcomes of Arthroscopy-Assisted Lower Trapezius Transfer Using Long Head of Biceps Tendon Autograft as an Interposition Graft for Massive Irreparable Rotator Cuff Tears |
Arthroscopy-Assisted Lower Trapezius Transfer Using Long Head of Biceps Tendon Autograft as an Interposition Graft for Massive Irreparable Rotator Cuff Tears |
Vad mäter studien?
Primära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
change in Constant-Murley Shoulder Score
Tidsram: 6 weeks, 3, 6,9,months and 1 year
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The Constant-Murley Shoulder Score (CMS) is a 100-point combined subjective and objective scoring system designed to assess overall shoulder function: Maximum Score: 100 points (indicates best possible shoulder function) Minimum Score: 0 points (indicates severe limitation/impairment) |
6 weeks, 3, 6,9,months and 1 year
|
Sekundära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
Visual analog score VAS
Tidsram: 6 weeks, 3, 6,9,months and 1 year
|
psychometric response scale used to measure subjective pain intensity, including shoulder pain: Standard Format: A 10 cm (100 mm) horizontal line anchored by two extreme descriptors at each end: 0 cm (0 mm): "No pain" 10 cm (100 mm): "Worst imaginable pain" (or "Worst pain ever felt") |
6 weeks, 3, 6,9,months and 1 year
|
Samarbetspartners och utredare
Sponsor
Studieavstämningsdatum
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Studiestart (Beräknad)
Primärt slutförande (Beräknad)
Avslutad studie (Beräknad)
Studieregistreringsdatum
Först inskickad
Först inskickad som uppfyllde QC-kriterierna
Första postat (Faktisk)
Uppdateringar av studier
Senaste uppdatering publicerad (Faktisk)
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senast verifierad
Mer information
Termer relaterade till denna studie
Andra studie-ID-nummer
- Azhar university Assiut
Plan för individuella deltagardata (IPD)
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IPD-planbeskrivning
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