The Influence of Repairing the Sub-scapularis on Outcomes After Reverse Arthroplasty

Study Purpose

The study is a prospective, multi-center, randomized blinded study to determine how repairing the subscapularis vs.#46; not repairing the subscapularis when subjects are implanted with the AltiVate Reverse® Shoulder System for reverse total shoulder arthroplasty affects isometric and isokinetic internal rotational strength. It is hypothesized that patients in which the subscapularis is repaired will have improved postoperative isometric and isokinetic internal rotational strength.

Recruitment Criteria

Accepts Healthy Volunteers

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

No
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.

Interventional
Eligible Ages 21 Years and Over
Gender All
More Inclusion & Exclusion Criteria

Inclusion Criteria:

1. Subject is ≥21 years of age. 2. Subject is scheduled for reverse shoulder arthroplasty with the AltiVate Reverse device due to primary diagnosis of severe arthropathy with a grossly deficient rotator cuff. 3. Subject's sub scapularis has been determined from MRI to be sufficient to repair. 4. Subject is willing and able to comply with the study schedule and assessments. 5. Subject is likely to be available for evaluation for the duration of the study. 6. Subject is willing and able to sign the informed consent.

Exclusion Criteria:

1. Subject is indicated for reverse shoulder arthroplasty for other indications (revision arthroplasty, proximal humerus fracture, etc.), addition of latissimus transfer or pectoralis major transfer. 2. Subject has metal allergies or sensitivity. 3. Subject has an active infection at or near the site of implantation. 4. Subject has a nonfunctional deltoid muscle. 5. Subject has neuromuscular compromise condition of the shoulder. 6. Subject has known active metastatic or neoplastic diseases, Paget's disease or Charcot's disease. 7. Subject is currently on or planning to be on chemotherapy or radiation. 8. Subject has had chemotherapy or radiation within the last 6 months. 9. Subject is currently taking > 5mg/day corticosteroids (e.g. prednisone), excluding inhalers, within 3 months prior to surgery. 10. Female subjects who are pregnant or planning to become pregnant within the study period. 11. In the investigator's opinion, the subject is unable to understand the study or be compliant with the follow up or has a history of non-compliance with medical advice. 12. Subject has a history of any cognitive or mental health status that would interfere with study participation. 13. Subject is abusing alcohol or drugs or is undergoing active treatment for substance abuse (e.g., recreational drugs, narcotics, or alcohol).

Trial Details

Trial ID:

This trial id was obtained from ClinicalTrials.gov, 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.

NCT03711175
Phase

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.

N/A
Lead Sponsor

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

Encore Medical, L.P.
Principal Investigator

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

Jessica Knowlton, MS, CRA
Principal Investigator Affiliation DJO Global
Agency Class

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

Industry
Overall Status Enrolling by invitation
Countries United States
Conditions

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

Severe Arthropathy With a Grossly Deficient Rotator Cuff
Additional Details

Reverse shoulder arthroplasty (RSA) is performed to provide improvement in pain relief and restoration of function in patients with rotator cuff tear arthropathy and massive irreparable rotator cuff tears . Traditional total shoulder designs failed to address the unique mechanics of shoulders with deficient rotator cuffs. Different prosthesis designs exist for RSA, all of which increase the deltoid lever arm to provide a stable fulcrum for active elevation in a rotator cuff deficient shoulder. The Reverse® Shoulder Prosthesis (RSP®) (DJO Surgical) sought to address issues correlated to the Grammont design by lateralizing the center of rotation as well as utilizing a central compressive screw with a 5.0-mm peripheral locking screws for fixation and a glenosphere . Despite the success of the lateralized design, the effect of the repair of the subscapularis tendon during RSA on shoulder strength, range of motion, and shoulder function remains inconclusive. The rationale for repairing the subscapularis during RSA include anatomic preservation of a functioning rotator cuff muscle, an increased potential for internal rotation, better joint protection, and more stability. The reasoning for not repairing the subscapularis include that it may be biomechanically unfavorable for both the deltoid and the posterior rotator cuff, limiting the range of motion. As such, this randomized study aims to address if subscapularis repair impacts isometric and isokinetic internal rotational strength, with shoulder function and complications as secondary objectives, when patients are implanted with the AltiVate Reverse® device. The study will take place at multiple sites across the United States and will be managed by the DJO Surgical Clinical Affairs Department.

Arms & Interventions

Arms

Other: Group A

The subscapularis is repaired. Receives device

Other: Group B

The subscapularis is not repaired. Receives device

Interventions

Procedure: - Subscapularis repair

Utilizing fiberwire, high tensile strength suture

Device: - Shoulder implant

Reverse shoulder arthroplasty device

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.

St. Luke's Hospital, Saint Louis, Missouri

Status

Address

St. Luke's Hospital

Saint Louis, Missouri, 63128

New York, New York

Status

Address

NYU Langone Center for Musculoskeletal Care

New York, New York, 10016

Rothman Institute, Philadelphia, Pennsylvania

Status

Address

Rothman Institute

Philadelphia, Pennsylvania, 19107

Texas Orthopedic Group, Houston, Texas

Status

Address

Texas Orthopedic Group

Houston, Texas, 77030