Functional and Radiographic Outcomes After Shoulder Surgery

Study Purpose

The objective of this study is twofold: First, to determine whether higher levels of pre-operative psychological distress predict worse outcomes after arthroscopic rotator cuff repair; second, to obtain functional outcomes (VAS pain, VAS satisfaction, VAS function, Simple Shoulder Test (SST) and American Shoulder and Elbow Surgeons (ASES) Score), physically examine and perform a radiographic analysis of patients at a minimum of 6 months after reverse total shoulder arthroplasty, total shoulder arthroplasty, arthroscopic scapulothoracic bursectomy, acromioclavicular joint reconstruction and arthroscopic rotator cuff repair.

Recruitment Criteria

Accepts Healthy Volunteers

Healthy volunteers are participants who do not have a disease or condition, or related conditions or symptoms

Study Type

An interventional clinical study is where participants are assigned to receive one or more interventions (or no intervention) so that researchers can evaluate the effects of the interventions on biomedical or health-related outcomes.

An observational clinical study is where participants identified as belonging to study groups are assessed for biomedical or health outcomes.

Searching Both is inclusive of interventional and observational studies.

Eligible Ages 18 Years and Over
Gender All
More Inclusion & Exclusion Criteria

Inclusion Criteria:

  • - Patients whose primary presenting complaint of shoulder pain and who then undergo arthroscopic rotator cuff repair performed by the principal investigator for full thickness rotator cuff tear will be eligible for inclusion.
All patients who have undergone reverse total shoulder arthroplasty, total shoulder arthroplasty utilizing a lesser tuberosity osteotomy, acromioclavicular joint reconstruction, arthroscopic scapulothoracic bursectomy or arthroscopic rotator cuff repair by the PI (RZT) will also be eligible for inclusion in the study. These will include patients both at the University of Utah as well as the Veteran's Administration Hospital in Salt Lake City. All patients presenting complain of shoulder pain will be given the DRAM survey preoperative and then evaluated a minimum of 6 months postoperative.

Exclusion Criteria:

  • - All patients who have undergone total shoulder arthroplasty not utilizing a lesser tuberosity osteotomy or who have prior failed rotator cuff repair in the affected shoulder will be excluded.
  • - All patients who have undergone an open repair of the supraspinatus or infraspinatus rotator cuff tendons will not be eligible.

Trial Details

Trial ID:

This trial id was obtained from, a service of the U.S. National Institutes of Health, providing information on publicly and privately supported clinical studies of human participants with locations in all 50 States and in 196 countries.


Phase 1: Studies that emphasize safety and how the drug is metabolized and excreted in humans.

Phase 2: Studies that gather preliminary data on effectiveness (whether the drug works in people who have a certain disease or condition) and additional safety data.

Phase 3: Studies that gather more information about safety and effectiveness by studying different populations and different dosages and by using the drug in combination with other drugs.

Phase 4: Studies occurring after FDA has approved a drug for marketing, efficacy, or optimal use.

Lead Sponsor

The sponsor is the organization or person who oversees the clinical study and is responsible for analyzing the study data.

University of Utah
Principal Investigator

The person who is responsible for the scientific and technical direction of the entire clinical study.

Robert z Tashjian, MD
Principal Investigator Affiliation University Of Utah Orthopedics Center
Agency Class

Category of organization(s) involved as sponsor (and collaborator) supporting the trial.

Overall Status Enrolling by invitation
Countries United States

The disease, disorder, syndrome, illness, or injury that is being studied.

Shoulder Pain, Osteoarthritis of Glenohumeral Joint, Rotator Cuff Tear Arthropathy
Additional Details

Clinical outcome studies have been performed in the evaluation of a variety of shoulder pathologies after surgical treatment. Among these disease processes include glenohumeral osteoarthritis, rotator cuff arthropathy, acromioclavicular separations and scapulothoracic bursitis. A variety of outcomes studies have been performed on these pathologies although few have utilized several functional outcome measures. Also with respect to each of these diagnoses, several specific areas of research regarding outcomes assessment have not been investigated. Glenohumeral osteoarthritis is one of the most common shoulder pathologies treated by orthopedic surgeons. For endstage osteoarthritis, an anatomic total shoulder arthroplasty provides excellent pain relief and functional improvement. In order to perform the replacement, the rotator cuff tendon in the front of the shoulder (subscapularis) needs to be taken down and then repaired at the completion of the case. There are three basic methods of takedown and repair: tenotomy, peel-off and lesser tuberosity osteotomy. The osteotomy has been compared clinically to tenotomy and found to provide a lower rate of subscapularis tears, higher outcome scores and universal healing evaluated using ultrasound and the PENN shoulder score.1 Gerber et al has also evaluated long-term outcomes of total shoulder arthroplasty with lesser osteotomy using the Constant score as a measure of outcomes.2 Unfortunately, many outcome studies evaluating total shoulder arthroplasty utilize the Simple Shoulder Test and the American Shoulder and Elbow Surgeons (ASES) Score which have not been evaluated. Also, osteotomy was performed only utilizing a "fleck" of bone instead of the entire lesser tuberosity. No studies to date have evaluated TSA with an osteotomy of the entire lesser tuberosity. Reverse total shoulder arthroplasty has shown be a predictable operation for the treatment of rotator cuff arthropathy with clinical improvements in both pain and function at long term. 3,4 Dislocation has been reported between 0% to 9% after reverse total shoulder arthroplasty and has been defined as one of the top three most common complications associated with reverse TSA.3-10 There is considerable debate regarding whether the subscapularis tendon needs repair after reverse TSA. Edwards et al reported a statistically significant reduction in dislocation rates from 9% to 0% with addition of subscapularis repair.10 These results had significant bias with regards to randomization of patients. Similarly, all patients in the non-repair group were at the initial portion of his learning curve. Consequently, the risk for instability is likely lower than reported in his series. Acromioclavicular joint separations represent one of the most common shoulder injuries accounting for approximately 9% of shoulder girdle injuries.11 Acromioclavicular injuries have been classified with increasing severity from I to VI based upon disruption of the various ligamentous and muscular supports including the acromioclavicular ligaments, coracoclavicular ligaments and deltotrapezial fascia.12 Recommended initial treatment for grade I to III injuries has been nonoperative with reasonable clinical results while initial surgical stabilization has been recommended for higher grade injuries.12-15. A variety of surgical stabilization techniques for acromioclavicular joint separations have been reported including the transfer of the coracoacromial ligament from the acromion to the end of the resected distal clavicle originally described by Weaver and Dunn in 1972.16 A modification of the Weaver-Dunn acromioclavicular reconstruction was subsequently described which included coracoclavicular stabilization with nonabsorbable suture.17 Despite this modification, residual subluxation or dislocation of the acromioclavicular joint has been identified in up to 29% of patients.17 Consequently, alternative constructs have been described including an anatomic reconstruction utilizing a tendon graft which has been shown to have superior biomechanical strength compared to a Weaver-Dunn reconstruction.18. As part of the surgical transition from the modified Weaver-Dunn reconstruction as described by Weinstein et al. to a reconstruction using a tendon graft, augmentation of the coracoclavicular suture fixation with either allograft or autograft tendon as well as performing the coracoacromial ligament transfer has been described.17,19 This differs from the anatomic reconstruction described by Mazzocca et al., as it includes both the transferred coracoacromial ligament and the hamstring graft for stabilization instead of just the graft.11 Coracoclavicular ligament reconstruction with a tendon graft has been reported as a treatment option for failed Weaver-Dunn reconstructions.20,21 Possible benefits of the combined reconstruction include improved construct strength and a vascularized ligament. Drawbacks include increased surgical dissection, increased operating room time and disruption of the coracoacromial arch. With the advances in arthroscopic techniques, acromioclavicular reconstructions utilizing a tendon graft are now being performed arthroscopically which has been described without the addition of coracoacromial ligament transfer.22 Reconstructions without coracoacromial ligament transfers may increase the ease of performing a reconstruction through smaller incisions with arthroscopic assistance. No study has evaluated the clinical effects of adding a coracoacromial ligament transfer to an acromioclavicular joint reconstruction utilizing a coracoclavicular tendon graft. Scapulothoracic bursitis or "snapping scapula syndrome" is an under-recognized shoulder disorder where the bursal sac between the scapula and chest wall becomes irritated and inflamed. The etiology is overuse causing reactive bursa formation between the scapula and thorax. If conservative measures fail as initial attempts at management, surgical excision of the inflamed bursa with resection of the superior medial angle of the scapula can be performed. The procedure can be performed either arthroscopically or open. A two-portal or three-portal technique can be utilized if performed arthroscopically. Very limited data exists regarding outcomes of two-portal or three-portal techniques with no use of validated patient-based outcome scores.23,24. Rotator cuff tearing is the most common shoulder pathology treated by orthopedic surgeons. Healing rates after rotator cuff repair have varied in the literature from less than 5% to 100% dependent on tear size, age, repair construct and muscle quality.25,26 A variety of methods have been used to repair the tendon. A recent biomechanical study has shown that repair with triple-loaded suture anchors have improved initial biomechanical properties compared to other constructs.27 No clinical data exists on healing after repair with triple loaded anchors or how healing effects function.

Contact a Trial Team

If you are interested in learning more about this trial, find the trial site nearest to your location and contact the site coordinator via email or phone. We also strongly recommend that you consult with your healthcare provider about the trials that may interest you and refer to our terms of service below.

University Of Utah Orthopedics Center, Salt Lake City, Utah



University Of Utah Orthopedics Center

Salt Lake City, Utah, 84108

Salt Lake City, Utah



Veterans Administration Hospital Salt Lake City

Salt Lake City, Utah, 84108