Cuff Rotator Syndrome Clinical Trial
Official title:
Neuropathy of the Suprascapular Nerve Before and After Reconstruction of the Cuff
The suprascapular nerve innervates the musculi supra- and infraspinatus, which, as part of
the rotator cuff, allow lifting and external rotation in the shoulder joint. Damage to this
nerve can lead to pain and functional deficit. Causes of injury are compression by bony /
ligamentous anomalies, fracture sequelae and traction damage. In the literature, a (often
subclinical) traction damage is increasingly claimed by a muscle retraction after rupture of
the supra- and / or infraspinatus tendon as a cause of pain and functional disturbances. The
retraction of the ruptured tendon-muscular unit is said to lead to traction damage of the
nerve, which can be demonstrated by pathological EMG derivations. By repositioning the tendon
to its outbreak site, the nerve is occasionally overstretched, so that individual authors
propagate a routine nerve decompression as prophylaxis. In individual cases, a previously
pathologic EMG result could be improved after reconstitution of an rotator cuff rupture.
However, prospective studies are not available.
It is not known how often a nerve damage is present before a rotator cuff operation and it is
not known how often the tendon repair leads to nerve damage or recovery of damage. It is not
known whether the surgical nerve decompression is associated with reduced postoperative pain
and what a profit or what risks bring about a routine decompression of the nerve to the
patient. To answer this question, this prospective randomized study is to be carried out.
On the basis of preoperative electromyography (EMG) and electroneurography (ENG), the
investigators would like to determine the frequency of suprascapular neuropathy in ruptures
of supra- and / or infraspinatus tendons and the risk factors for their presence.
In a ruptured rotator cuff, the muscle is partly retracted so much that the innervating nerve
(suprascapular nerve) is stretched and has pathological neurological findings. The
Investigators now want to analyze how the arthroscopic reconstruction of the nasal
suprascapular nerve affects the pre-operative neuropathy. Does the pre-existing nerve recover
by decompression (liberation) from surrounding / entangling tissue or does decompression have
no influence on measurable neurology? Other patients with rotator cuff ruptures have normal
neurological findings preoperatively despite severe retraction of the muscular / tendon unit.
In these cases, the investigators are interested in whether the mobilization and
reconstruction of the torn muscle / tendon unit leads to a neurologically measurable
elongation of the nerve. This nerve stretching is a possible explanation for protracted
postoperative pain. With the postoperative electrophysiological measurements we can quantify
this nerve change.
The comparison between preoperative and postoperative neurology findings allows confirmation
or refutation of our hypothesis.
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| Status | Clinical Trial | Phase | |
|---|---|---|---|
| Withdrawn |
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