Rotator Cuff Tear Clinical Trial
Official title:
Effect of Surgical Wait Times on Outcomes of Rotator Cuff Surgery
The purpose of this prospective randomized controlled trial is to compare post-operative outcome between participants undergoing expedited surgery compared to those proceeding through a 'typical' wait time process. A secondary purpose is to evaluate the progression of rotator cuff tear size from the time of initial consult to the time of surgery.
Consented patients will undergo a pre-operative assessment conducted by a study
physiotherapist, including the following: 1) demographic information (age, gender, height,
weight, smoking status, employment, recreational activities, time of injury, etc.); 2)
shoulder ROM, 3) shoulder strength using a handheld dynamometer, and 4) subjective
shoulder-specific outcome measures which include the Western Ontario Rotator Cuff Score
(WORC), American Shoulder and Elbow Score (ASES), and Simple Shoulder Test (SST).
Measurement of tear size will also be documented by an experienced radiologist from the
initial MRI or ultrasound.
Patients will undergo initial consultation with the orthopaedic surgeon to confirm
suitability for surgical management. If deemed appropriate to continue as a participant, the
individual participants will be randomized to one of the two study groups. If in the
Expedited group, the patient will proceed to have rotator cuff repair surgery within 3
months of the initial consult with the sports medicine physician. If randomized to the
Control or 'Typical Wait Time' Group, surgery will take place no earlier than 9 months and
no later than 12 months after the sports medicine physician consult.
Just prior to surgery, a second diagnostic imaging test will take place, either ultrasound
or MRI, to document progress in tear size and any secondary pathology in the control group.
Diagnostic test findings will be confirmed intraoperatively. All rotator cuff repairs will
be performed by one of four fellowship trained orthopaedic surgeons.
The control study group will be sent the subjective questionnaires at 8 week intervals while
they are waiting for surgery. Post-surgery study follow-ups will take place at 6, 12, and 24
months for both groups. All patients will be provided with the same rehabilitation protocol
including pain management, range of motion and strengthening exercises. The same data as
that collected pre-surgery will be repeated as well as any occurrences of failure of the
repair. Failure of the repair is defined as ongoing severe pain, limited ROM, and/or
decreased strength. If a failure occurs, follow-ups will continue until 24 months following
failure or 24 months following revision surgery, if performed.
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