Evaluating the Use of a Bioinductive Graft in Treating Massive Rotator Cuff Tears
Rotator Cuff Tear | Rotator Cuff InjuryThe rotator cuff is a complex of 4 tendons that aid in stabilizing and moving the shoulder. Rotator cuff tears are common shoulder injuries in adults. While some tears can be managed by physiotherapy, other rotator cuff tears will require surgery. On occasion, when a person has had a large rotator cuff tear for a long period of time, the tear can grow and the tendons retract. This effect makes it very difficult for the tendons to be repaired to their normal spot.
The most common surgical technique employed to manage a tear that cannot be repaired is to remove all unhealthy, inflamed scar tissue in a process called debridement. Often there is a bone spur that must be shaved down as well. This can help to reduce the pain in the patient as well as assist the range of motion slightly but will not prevent the tear becoming larger. This will also not prevent a re-tear of the tendons.
Recently, surgeons have begun using a variety of materials to help reconstruct torn rotator cuffs. New grafts made of highly purified collagen from bovine tendons has been used to bridge large gaps in the tendons, and repair the tendon back to the bone. This technique has been done many times by skilled shoulder surgeons in Canada, the United States and around the world.
Initial reports by surgeons who do this procedure show that the patients have less pain and better range of motion than before the surgery. Shoulder surgeons do not know which is the better treatment for large rotator cuff tears. Both treatments (graft and debridement) can reduce pain and improve movement of the shoulder. The purpose of this study is to help determine whether patients who receive an allograft have better function and fewer re-tear at one year after surgery than those who received a debridement alone.
null
Participation Requirements
-
Sex:
ALL -
Eligible Ages:
18 and up
Participation Criteria
Inclusion Criteria:
* Magnetic resonance imaging (MRI) proven diagnosis of a large \>3cm tear of the shoulder rotator cuff in a competent adult (\>18 years of age).
Exclusion Criteria:
* Patients with subscapular tear
* Glenohumeral osteoarthritis
* A normalized WORC score \>70 (where scores range between 0-100, and 100 is the best outcome)
* Uncontrolled diabetes (Hgb A1C \>7%)
* Pregnancy
* Presence of local or systemic infection
* Inability to cooperate with and/or comprehend post-operative instructions
* Nonvascular surgical sites (MRI proven)
* Poor nutritional state (Alb \<30 g/L)
* Cancer
* Paralysis of the shoulder
* Contracture of the shoulder
* Presence of cuff tear arthropathy or osteoarthritis of the shoulder
* Patients unable to provide informed consent for the study
Study Location
Nova Scotia Health Authority
Nova Scotia Health AuthorityHalifax, Nova Scotia
Canada
Contact Study Team
- Study Sponsored By
- Nova Scotia Health Authority
- Participants Required
- More Information
- Study ID:
NCT04248751