Massive Rotator Cuff Tears Clinical Trial
Official title:
Arthroscopic Treatment of Massive Rotator Cuff Tears With Debridement and or Biodegradable Spacer: a Prospective Randomized Clinical Trial.
Massive rotator cuff tears are common in the adult population. It is estimated that about 12
% of adults 60 years of age or older suffer from a rotator cuff injury. About 40 % of these
injuries are classified as massive rotator cuff tears (MRCT). MRCT propose a great challenge
to the affected patient and its doctor. It is a painful condition with few treatment options.
The study aims to investigate the operative treatment for MRCT with the new treatment option
proposed by Senecovic. Insertion of a biodegradable balloon as a subacromial spacer has
proven promising results so far. To this date there is only small and non-randomized studies
on the subject. AMRIS are planning to do a randomized controlled study where group A is
treated with arthroscopic debridement, biceps tenotomy and biodegradable spacer, while group
B, the control group are treated with arthroscopic debridement and biceps tenotomy.
The study is designed as a double blinded randomized controlled trial. The physiotherapist
responsible for the clinical testing and the patient are both blinded. The surgeon knows
which group the patient is in but is not responsible for any of the testing. We will
randomize with envelopes perioperatively. The participants are randomized in hence "ballon"
or "not ballon". In advance of the randomization the surgeon will evaluate if the patient is
candidate for partial suture before randomization. We plan to stratify the patients with
partial suture to ensure homogeneity between the groups.
The operation will start with arthroscopic debridement and biceps tenotomy in both groups.
The patients are thereby evaluated for partial suture and randomized. The insertion of the
subacromial spacer is done at the end of the operation for those patients randomized to the
group "balloon". Peroperatively the surgeon will classify the grade of osteoarthritis with
Outerbridge classification and the state of the rotator cuff and the long head of the biceps
tendon.
Postoperative mobilization will be the following:
- 0-2 weeks: Immobilization in a sling. The participant is advised to do simple exercises
for shoulder mobilization. Restriction of movement above shoulder level.
- 2-6 weeks: Free mobilization. Advised to avoid heavy lifting.
- 6-12 weeks: Work on increasing range of motion, gradually introduce weight lifting.
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