Clinical Trials Logo

Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT00923858
Other study ID # IRB# 201103230
Secondary ID 5R01AR051026
Status Completed
Phase
First received
Last updated
Start date July 1, 2005
Est. completion date June 2022

Study information

Verified date August 2022
Source Washington University School of Medicine
Contact n/a
Is FDA regulated No
Health authority
Study type Observational

Clinical Trial Summary

The purpose of this project is to provide information which can help us understand what happens over time to rotator cuff tears. In this study, the investigators will follow a population of people with rotator cuff tears that do not hurt (asymptomatic) and to establish the probability that an asymptomatic rotator cuff tear, identified in the context of contralateral symptoms, will become symptomatic over time. To determine with ultrasound the probability that a rotator cuff tear will enlarge over time. To determine if symptom progression correlates with enlargement of the rotator cuff tear and/or degenerative changes on radiographs. In order to obtain data, study subjects will be recalled for follow-up at 1 year time points over a 5 year period. The study subjects will have repeat physical exam, ultrasound and radiographic examinations. A control group of normal patients will also be followed for comparison.


Description:

The specific aims of our study are: 1. To determine the probability that an asymptomatic rotator cuff tear will become symptomatic over time. 2. To determine which epidemiological factors correlate with symptomatic progression. 3. To determine if symptomatic progression correlates with enlargement of the rotator cuff tear as determined at sonography. 4. To determine the value of routine sonographic scanning of the asymptomatic shoulder.


Recruitment information / eligibility

Status Completed
Enrollment 495
Est. completion date June 2022
Est. primary completion date June 2022
Accepts healthy volunteers No
Gender All
Age group 18 Years to 75 Years
Eligibility Group 1 (Cohorts I & II) Inclusion Criteria: - Participants who enrolled at age 65 years or younger will remain in the study. - Less than 11 annual visits of non-operative surveillance of study shoulder. - Less than 3 annual visits following a rotator cuff repair of study shoulder. Group 1 (Cohorts I & II) Exclusion Criteria: - Workman's Compensation claim involving the shoulders. - Use of crutch, cane or weight-bearing device on study shoulder. - Moderate or severe glenohumeral arthritis. - Inflammatory or other disease process affecting neurological/musculoskeletal systems that may impact weight-bearing activities or normal use of upper body. - Inability to return for routine study visits. - Traumatic injury to rotator cuff. - Rotator Cuff Tear greater than 30mm in width. - Advanced fatty muscle degeneration. Patients who are currently enrolled but require a shoulder replacement will not remain in the study. Cohorts I & II will now be considered the control group for comparison to those enrolled in this next recruitment period. Group 2 (Cohort III) Inclusion Criteria: - Age 65 years or younger. - Surgical candidate for primary, double-row repair of a rotator. - Able to comply with post operative therapy protocol. - Bilateral partial or full thickness rotator cuff tears: one symptomatic requiring surgery and the contralateral shoulder asymptomatic. Group 2 (Cohort III) Exclusion Criteria: - Workman's Compensation claim involving the shoulders. - Use of crutch, cane or weight-bearing device on study shoulder. - Moderate or severe glenohumeral arthritis. - Inflammatory or other disease process affecting neurological/musculoskeletal systems that may impact weight-bearing activities or normal use of upper body. - Inability to return for routine study visits. - Traumatic injury to rotator cuff. - Rotator Cuff Tear greater than 30mm in width. - Advanced fatty muscle degeneration.

Study Design


Related Conditions & MeSH terms


Locations

Country Name City State
United States Washington University School of Medicine Saint Louis Missouri

Sponsors (3)

Lead Sponsor Collaborator
Washington University School of Medicine National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institutes of Health (NIH)

Country where clinical trial is conducted

United States, 

References & Publications (50)

Baumgarten KM, Gerlach D, Galatz LM, Teefey SA, Middleton WD, Ditsios K, Yamaguchi K. Cigarette smoking increases the risk for rotator cuff tears. Clin Orthop Relat Res. 2010 Jun;468(6):1534-41. doi: 10.1007/s11999-009-0781-2. Epub 2009 Mar 13. — View Citation

Bright AS, Torpey B, Magid D, Codd T, McFarland EG. Reliability of radiographic evaluation for acromial morphology. Skeletal Radiol. 1997 Dec;26(12):718-21. — View Citation

Codman EA, Akerson IB. THE PATHOLOGY ASSOCIATED WITH RUPTURE OF THE SUPRASPINATUS TENDON. Ann Surg. 1931 Jan;93(1):348-59. — View Citation

COTTON RE, RIDEOUT DF. TEARS OF THE HUMERAL ROTATOR CUFF; A RADIOLOGICAL AND PATHOLOGICAL NECROPSY SURVEY. J Bone Joint Surg Br. 1964 May;46:314-28. — View Citation

Deutsch A, Altchek DW, Schwartz E, Otis JC, Warren RF. Radiologic measurement of superior displacement of the humeral head in the impingement syndrome. J Shoulder Elbow Surg. 1996 May-Jun;5(3):186-93. — View Citation

Dunn WR, Schackman BR, Walsh C, Lyman S, Jones EC, Warren RF, Marx RG. Variation in orthopaedic surgeons' perceptions about the indications for rotator cuff surgery. J Bone Joint Surg Am. 2005 Sep;87(9):1978-84. — View Citation

Galatz LM, Ball CM, Teefey SA, Middleton WD, Yamaguchi K. The outcome and repair integrity of completely arthroscopically repaired large and massive rotator cuff tears. J Bone Joint Surg Am. 2004 Feb;86(2):219-24. — View Citation

Goodman RS. Abnormal findings on magnetic resonance images of asymptomatic shoulders. J Bone Joint Surg Am. 1996 Apr;78(4):633. — View Citation

Goutallier D, Postel JM, Bernageau J, Lavau L, Voisin MC. Fatty muscle degeneration in cuff ruptures. Pre- and postoperative evaluation by CT scan. Clin Orthop Relat Res. 1994 Jul;(304):78-83. — View Citation

Hamid N, Omid R, Yamaguchi K, Steger-May K, Stobbs G, Keener JD. Relationship of radiographic acromial characteristics and rotator cuff disease: a prospective investigation of clinical, radiographic, and sonographic findings. J Shoulder Elbow Surg. 2012 O — View Citation

Harryman DT 2nd, Mack LA, Wang KY, Jackins SE, Richardson ML, Matsen FA 3rd. Repairs of the rotator cuff. Correlation of functional results with integrity of the cuff. J Bone Joint Surg Am. 1991 Aug;73(7):982-9. — View Citation

Hollister MS, Mack LA, Patten RM, Winter TC 3rd, Matsen FA 3rd, Veith RR. Association of sonographically detected subacromial/subdeltoid bursal effusion and intraarticular fluid with rotator cuff tear. AJR Am J Roentgenol. 1995 Sep;165(3):605-8. — View Citation

Kamath G, Galatz LM, Keener JD, Teefey S, Middleton W, Yamaguchi K. Tendon integrity and functional outcome after arthroscopic repair of high-grade partial-thickness supraspinatus tears. J Bone Joint Surg Am. 2009 May;91(5):1055-62. doi: 10.2106/JBJS.G.00118. Erratum in: J Bone Joint Surg Am. 2009 Aug;91(8):1995. — View Citation

Keener JD, Steger-May K, Stobbs G, Yamaguchi K. Asymptomatic rotator cuff tears: patient demographics and baseline shoulder function. J Shoulder Elbow Surg. 2010 Dec;19(8):1191-8. doi: 10.1016/j.jse.2010.07.017. Epub 2010 Oct 27. — View Citation

Keener JD, Wei AS, Kim HM, Paxton ES, Teefey SA, Galatz LM, Yamaguchi K. Revision arthroscopic rotator cuff repair: repair integrity and clinical outcome. J Bone Joint Surg Am. 2010 Mar;92(3):590-8. doi: 10.2106/JBJS.I.00267. — View Citation

Keener JD, Wei AS, Kim HM, Steger-May K, Yamaguchi K. Proximal humeral migration in shoulders with symptomatic and asymptomatic rotator cuff tears. J Bone Joint Surg Am. 2009 Jun;91(6):1405-13. doi: 10.2106/JBJS.H.00854. — View Citation

Keyes EL. Observations on Rupture of the Supraspinatus Tendon: Based Upon a Study of Seventy-Three Cadavers. Ann Surg. 1933 Jun;97(6):849-56. — View Citation

Kim HM, Dahiya N, Teefey SA, Keener JD, Galatz LM, Yamaguchi K. Relationship of tear size and location to fatty degeneration of the rotator cuff. J Bone Joint Surg Am. 2010 Apr;92(4):829-39. doi: 10.2106/JBJS.H.01746. — View Citation

Kim HM, Dahiya N, Teefey SA, Keener JD, Yamaguchi K. Sonography of the teres minor: a study of cadavers. AJR Am J Roentgenol. 2008 Mar;190(3):589-94. doi: 10.2214/AJR.07.2960. — View Citation

Kim HM, Dahiya N, Teefey SA, Middleton WD, Stobbs G, Steger-May K, Yamaguchi K, Keener JD. Location and initiation of degenerative rotator cuff tears: an analysis of three hundred and sixty shoulders. J Bone Joint Surg Am. 2010 May;92(5):1088-96. doi: 10. — View Citation

Kim HM, Teefey SA, Zelig A, Galatz LM, Keener JD, Yamaguchi K. Shoulder strength in asymptomatic individuals with intact compared with torn rotator cuffs. J Bone Joint Surg Am. 2009 Feb;91(2):289-96. doi: 10.2106/JBJS.H.00219. — View Citation

Kitay GS, Iannotti JP, Williams GR, Haygood T, Kneeland BJ, Berlin J. Roentgenographic assessment of acromial morphologic condition in rotator cuff impingement syndrome. J Shoulder Elbow Surg. 1995 Nov-Dec;4(6):441-8. — View Citation

Kowalsky MS, Keener JD. Revision arthroscopic rotator cuff repair: repair integrity and clinical outcome: surgical technique. J Bone Joint Surg Am. 2011 Mar;93 Suppl 1:62-74. doi: 10.2106/JBJS.J.01173. — View Citation

Mall NA, Kim HM, Keener JD, Steger-May K, Teefey SA, Middleton WD, Stobbs G, Yamaguchi K. Symptomatic progression of asymptomatic rotator cuff tears: a prospective study of clinical and sonographic variables. J Bone Joint Surg Am. 2010 Nov 17;92(16):2623-33. doi: 10.2106/JBJS.I.00506. — View Citation

Middleton WD, Edelstein G, Reinus WR, Melson GL, Murphy WA. Ultrasonography of the rotator cuff: technique and normal anatomy. J Ultrasound Med. 1984 Dec;3(12):549-51. — View Citation

Middleton WD, Payne WT, Teefey SA, Hildebolt CF, Rubin DA, Yamaguchi K. Sonography and MRI of the shoulder: comparison of patient satisfaction. AJR Am J Roentgenol. 2004 Nov;183(5):1449-52. — View Citation

Middleton WD, Reinus WR, Totty WG, Melson CL, Murphy WA. Ultrasonographic evaluation of the rotator cuff and biceps tendon. J Bone Joint Surg Am. 1986 Mar;68(3):440-50. — View Citation

Middleton WD, Reinus WR, Totty WG, Melson GL, Murphy WA. US of the biceps tendon apparatus. Radiology. 1985 Oct;157(1):211-5. — View Citation

Middleton WD, Teefey SA, Yamaguchi K. Sonography of the rotator cuff: analysis of interobserver variability. AJR Am J Roentgenol. 2004 Nov;183(5):1465-8. — View Citation

Middleton WD. Ultrasonography of the shoulder. Radiol Clin North Am. 1992 Sep;30(5):927-40. Review. — View Citation

Milgrom C, Schaffler M, Gilbert S, van Holsbeeck M. Rotator-cuff changes in asymptomatic adults. The effect of age, hand dominance and gender. J Bone Joint Surg Br. 1995 Mar;77(2):296-8. — View Citation

Miniaci A, Dowdy PA, Willits KR, Vellet AD. Magnetic resonance imaging evaluation of the rotator cuff tendons in the asymptomatic shoulder. Am J Sports Med. 1995 Mar-Apr;23(2):142-5. — View Citation

Norwood LA, Barrack R, Jacobson KE. Clinical presentation of complete tears of the rotator cuff. J Bone Joint Surg Am. 1989 Apr;71(4):499-505. — View Citation

Paletta GA Jr, Warner JJ, Warren RF, Deutsch A, Altchek DW. Shoulder kinematics with two-plane x-ray evaluation in patients with anterior instability or rotator cuff tearing. J Shoulder Elbow Surg. 1997 Nov-Dec;6(6):516-27. — View Citation

Poppen NK, Walker PS. Normal and abnormal motion of the shoulder. J Bone Joint Surg Am. 1976 Mar;58(2):195-201. — View Citation

Prickett WD, Teefey SA, Galatz LM, Calfee RP, Middleton WD, Yamaguchi K. Accuracy of ultrasound imaging of the rotator cuff in shoulders that are painful postoperatively. J Bone Joint Surg Am. 2003 Jun;85(6):1084-9. — View Citation

Roztocil K, Oliva I, Prerovský I, Linhart J. The effect of hydroxyethylrutoside and its combination with acetylsalicylic acid in patients with obliterative atherosclerosis. Cor Vasa. 1989;31(2):128-33. — View Citation

Sher JS, Uribe JW, Posada A, Murphy BJ, Zlatkin MB. Abnormal findings on magnetic resonance images of asymptomatic shoulders. J Bone Joint Surg Am. 1995 Jan;77(1):10-5. — View Citation

Sofka CM, Haddad ZK, Adler RS. Detection of muscle atrophy on routine sonography of the shoulder. J Ultrasound Med. 2004 Aug;23(8):1031-4. — View Citation

Strobel K, Hodler J, Meyer DC, Pfirrmann CW, Pirkl C, Zanetti M. Fatty atrophy of supraspinatus and infraspinatus muscles: accuracy of US. Radiology. 2005 Nov;237(2):584-9. Epub 2005 Sep 28. — View Citation

Tashjian RZ, Hollins AM, Kim HM, Teefey SA, Middleton WD, Steger-May K, Galatz LM, Yamaguchi K. Factors affecting healing rates after arthroscopic double-row rotator cuff repair. Am J Sports Med. 2010 Dec;38(12):2435-42. doi: 10.1177/0363546510382835. Epub 2010 Oct 28. — View Citation

Teefey SA, Middleton WD, Bauer GS, Hildebolt CF, Yamaguchi K. Sonographic differences in the appearance of acute and chronic full-thickness rotator cuff tears. J Ultrasound Med. 2000 Jun;19(6):377-8; quiz 383. — View Citation

Teefey SA, Middleton WD, Payne WT, Yamaguchi K. Detection and measurement of rotator cuff tears with sonography: analysis of diagnostic errors. AJR Am J Roentgenol. 2005 Jun;184(6):1768-73. — View Citation

Teefey SA, Rubin DA, Middleton WD, Hildebolt CF, Leibold RA, Yamaguchi K. Detection and quantification of rotator cuff tears. Comparison of ultrasonographic, magnetic resonance imaging, and arthroscopic findings in seventy-one consecutive cases. J Bone Joint Surg Am. 2004 Apr;86(4):708-16. — View Citation

Teefey SA. Shoulder sonography: why we do it. J Ultrasound Med. 2012 Sep;31(9):1325-31. — View Citation

Tyson LL, Crues JV 3rd. Pathogenesis of rotator cuff disorders. Magnetic resonance imaging characteristics. Magn Reson Imaging Clin N Am. 1993 Sep;1(1):37-46. Review. — View Citation

Wall LB, Teefey SA, Middleton WD, Dahiya N, Steger-May K, Kim HM, Wessell D, Yamaguchi K. Diagnostic performance and reliability of ultrasonography for fatty degeneration of the rotator cuff muscles. J Bone Joint Surg Am. 2012 Jun 20;94(12):e83. doi: 10.2 — View Citation

Yamaguchi K, Ditsios K, Middleton WD, Hildebolt CF, Galatz LM, Teefey SA. The demographic and morphological features of rotator cuff disease. A comparison of asymptomatic and symptomatic shoulders. J Bone Joint Surg Am. 2006 Aug;88(8):1699-704. — View Citation

Yamaguchi K, Sher JS, Andersen WK, Garretson R, Uribe JW, Hechtman K, Neviaser RJ. Glenohumeral motion in patients with rotator cuff tears: a comparison of asymptomatic and symptomatic shoulders. J Shoulder Elbow Surg. 2000 Jan-Feb;9(1):6-11. — View Citation

Yamaguchi K, Tetro AM, Blam O, Evanoff BA, Teefey SA, Middleton WD. Natural history of asymptomatic rotator cuff tears: a longitudinal analysis of asymptomatic tears detected sonographically. J Shoulder Elbow Surg. 2001 May-Jun;10(3):199-203. — View Citation

* Note: There are 50 references in allClick here to view all references

Outcome

Type Measure Description Time frame Safety issue
Other Physical Examination by the study coordinator (Range of motion) Research team member measures shoulder range of motion using a goniometer. Through study completion, an average of 1 per year
Other Physical Examination by the study coordinator (Strength) Research team member measures shoulder strength measured with a dynamometer. Through study completion, an average of 1 per year
Primary Standardized Shoulder Ultrasound & Radiographs The ultrasound involves measurement of rotator cuff tear (if present) and assessment of muscle degeneration. Radiographs will be used to document any bony changes. Through study completion, an average of 1 per year
Secondary American Shoulder & Elbow Survey (ASES) Assessment of patient-rated shoulder pain and function/disability. Questions involve activities of daily living that reflect the use of the shoulder & elbow in different planes of motion. Pain and weakness with various activities are also addressed. (Range 0-100, higher scores indicate better outcomes) Through study completion, an average of 1 per year
Secondary Western Ontario Rotator Cuff (WORC) Index Disease-specific quality of life questionnaire, evaluating the change in symptoms and functional ability, specific to rotator cuff tendinopathy. (Range: 0-2100, normalized to 0-100, higher scores indicate worst possible symptoms) Through study completion, an average of 1 per year
Secondary Short Form Health Survey (SF-12) General health assessment composed of two scales, Physical Component Summary and Mental Component Summary (Range: 0-100, higher scores indicate better health) Through study completion, an average of 1 per year
See also
  Status Clinical Trial Phase
Completed NCT03663036 - Arthroscopic Superior Capsular Reconstruction With Fascia Lata Autograft - Survivorship of the Autograft Analysis N/A
Withdrawn NCT03319784 - Analysis for NSAID VS Corticosteroid Shoulder Injection in Diabetic Patients Phase 4
Suspended NCT03290196 - The Effect of EXPAREL® on Postsurgical Pain, and the Use of Narcotics Phase 4
Active, not recruiting NCT03091075 - Oxandrolone Rotator Cuff Trial N/A
Completed NCT03380533 - Buprenorphine Transdermal Patches in Arthroscopic Rotator Cuff Repair Phase 2/Phase 3
Completed NCT04566939 - A Long Term Follow-Up of Rotator Cuff Tear Patients Treated With Integrated Complementary and Alternative Medicine
Active, not recruiting NCT02716441 - Rotator Cuff Failure With Continuity
Completed NCT03540030 - Opioid-Free Shoulder Arthroplasty Phase 4
Completed NCT02298023 - Treatment of Tendon Injury Using Allogenic Adipose-derived Mesenchymal Stem Cells (Rotator Cuff Tear) Phase 2
Completed NCT02850211 - A Selective COX-2 Inhibitor Provides Pain Control But Hinders Healing Following Arthroscopic Rotator Cuff Repair Phase 4
Completed NCT01383239 - Impact of Postoperative Management on Outcomes and Healing of Rotator Cuff Repairs N/A
Completed NCT01459536 - Assessment of Muscle Function and Size in Older Adults With Rotator Cuff Tear N/A
Completed NCT01170312 - Arthroscopic Surgery and Platelet Rich Plasma In Rotator Cuff Tear Evaluation N/A
Completed NCT01204606 - Arthroscopic Rotator Cuff Repair With Multimodal Analgesia(MMA) N/A
Terminated NCT00936559 - Study Evaluating Safety Of BMP-655/ACS As An Adjuvant Therapy For Rotator Cuff Repair Phase 1
Completed NCT00852657 - Comparison of Tendon Repair and Physiotherapy in the Treatment of Small and Medium-sized Tears of the Rotator Cuff N/A
Active, not recruiting NCT00182299 - An RCT to Compare the Outcomes of Patients With Large Rotator Cuff Repair That Undergo Repair With or Without SIS Phase 4
Recruiting NCT06120998 - Quality of Life After Arthroscopic Rotator Cuff Repair
Completed NCT05897866 - Sayed Issa's Hybrid Shoulder Arthroscopic-Open Surgical Management (HSSM) N/A
Completed NCT02644564 - Early Clinical Examination and Ultrasonography Screening of Acute Soft Tissue Shoulder Injuries N/A