Clinical Trial Details
— Status: Not yet recruiting
Administrative data
NCT number |
NCT06154460 |
Other study ID # |
SSM-SI-35 |
Secondary ID |
|
Status |
Not yet recruiting |
Phase |
|
First received |
|
Last updated |
|
Start date |
December 18, 2023 |
Est. completion date |
March 29, 2024 |
Study information
Verified date |
October 2023 |
Source |
Izmir Democracy University |
Contact |
Ferruh Taspinar, Prof. Dr. |
Phone |
05426853877 |
Email |
fztferruh[@]hotmail.com |
Is FDA regulated |
No |
Health authority |
|
Study type |
Observational
|
Clinical Trial Summary
Shoulder instability is the inability to retain the humeral head in the glenoid fossa. The
incidence of instability is 8.2 to 23.9 per 100,000 person-years with an estimated prevalence
of 1.7%. The most common shoulder instability with a rate of 98% is anterior dislocation, in
which the humeral head is displaced anterior to the glenoid. Conservative and surgical
treatments of instability are available. There are many controversial issues related to these
methods in the literature. For example; an atrophy and functional loss in the infraspinatus
after reimplissage, atrophy and loss of proprioception in the muscles around the shoulder
after capsular repair, and loss of proprioception after the laterjet procedure have been
reported.Therefore, the aim of this study was to compare different surgical stabilization
methods in terms of pain, proprioceptive sensation, functional status and muscle activation
in recurrent anterior shoulder instability, which is very common in adults.
Description:
Shoulder instability is the inability to retain the humeral head in the glenoid fossa. The
incidence of instability is 8.2 to 23.9 per 100,000 person-years with an estimated prevalence
of 1.7%. The most common shoulder instability with a rate of 98% is anterior dislocation, in
which the humeral head is displaced anterior to the glenoid. It is more common in young
males. While damage is limited to the capsule and labrum in most instabilities seen in young
people, rotator cuff tear is also observed in 89% of those over 40 years of age. Trauma is
the main cause of shoulder instability. While 96% of shoulder instabilities develop as a
result of a blow to the arm in abduction or external rotation of the shoulder with excessive
flexion, approximately 4% occur without trauma. Anterior instability occurs when the shoulder
is forced into abduction and external rotation by impact, and posterior instability occurs
when the shoulder in slight flexion and adduction is hit. The glenohumeral joint is an
unstable joint because the depth and size of the glenoid fossa are not fully compatible with
the humerus and as a result, the range of motion is wider compared to other joints in the
body. While articular surface congruence, articular version, glenoid labrum, capsule and
ligaments constitute static factors in ensuring stability; rotator cuff, biceps tendon,
intra-articular negative pressure and muscles that form scapulothoracic movements (Trapezoid,
Serratus Anterior, Rhomboids, Latissimus Dorsi) constitute dynamic factors. Insufficiency of
one or more of these structures causes instability. Conservative and surgical treatments of
instability are available. Conservative treatment includes nonoperative methods. These
methods consist of electrophysical agents, heat-light agents, exercise and manual treatment
methods and proceed through a certain protocol according to the patient's condition and
symptoms. In cases where medical and physical therapies are not sufficient, surgical
treatment procedures are initiated.
Reimplisasagge, capsular reconstruction and laterjet methods are commonly used in surgical
treatments. Reimplissagge operation, which means "to fill", is an open procedure designed to
limit the engagement of Hill-Sachs deformity by passing the infraspinatus into the Hill-Sachs
defect. The possibility of loss of internal and external rotation as a result of
infraspinatus tendon transfer after reimplissage is a matter of debate. Allografts or
autografts are used for capsular reconstruction, which is another surgical method. In the
procedure performed with capsular repair and grafts, the capsule is strengthened and
stabilization is attempted. The laterjet procedure is an operation in which the coracoid
process is transferred to the glenoid rim with a screw.
There are many controversial issues related to these methods in the literature. For example;
an atrophy and functional loss in the infraspinatus after reimplissage, atrophy and loss of
proprioception in the muscles around the shoulder after capsular repair, and loss of
proprioception after the laterjet procedure have been reported. Therefore, the aim of our
study was to compare these commonly applied methods in terms of pain, proprioceptive
sensation, functional status and muscle activation and the hypothesis of the study was as
follows; Hypothesis of the Study: Laterjet, reimplissage and capsular reconstruction surgical
procedures in recurrent anterior shoulder instabilities affect pain, proprioceptive
sensation, functional status and muscle activation differently.