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An Outcomes Study Utilizing Allomend(R) HD for Superior Capsular Reconstruction

Recruiting
Conditions
Rotator Cuff Tear or Rupture, Not Specified as Traumatic
Registration Number
NCT04615117
Lead Sponsor
Western Orthopaedics Research and Education Foundation
Brief Summary

Rotator cuff tears can usually be repaired with excellent results, however some chronic, extensive rotator cuff tears are not reparable secondary to tendon retraction with inelasticity, muscle atrophy, and fatty infiltration. Arthroscopic superior capsular reconstruction (SCR) utilizing allograft or autograft tissue has been shown to restore superior glenohumeral stability and function of the shoulder joint in patients with irreparable rotator cuff tears. Grafts utilized for SCR have included fascia lata, hamstring autograft, human acellular dermal tissue matrix (HADTM), and acellular porcine dermal xenograft. Due to donor morbidity associated with autografts and the graft rejection potential of xenograft, HADTM has become a common graft of choice for SCR. The purpose of this study is to determine if patients treated with SCR using AlloMend have acceptable clinical and anatomic outcomes.

Detailed Description

Rotator cuff tears can usually be repaired with excellent results, however some chronic, extensive rotator cuff tears are not reparable secondary to tendon retraction with inelasticity, muscle atrophy, and fatty infiltration. Arthroscopic superior capsular reconstruction (SCR) utilizing allograft or autograft tissue has been shown to restore superior glenohumeral stability and function of the shoulder joint in patients with irreparable rotator cuff tears.Grafts utilized for SCR have included fascia lata, hamstring autograft, human acellular dermal tissue matrix (HADTM), and acellular porcine dermal xenograft. Due to donor morbidity associated with autografts and the graft rejection potential of xenograft, HADTM has become a common graft of choice for SCR. The purpose of this study is to determine if patients treated with SCR using AlloMend have acceptable clinical and anatomic outcomes. We predict there will be significant improvement in radiographic, clinical, and patient reported outcomes in patients undergoing SCR for extensive, primarily irreparable rotator cuff tears when AlloMend allograft is utilized.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
25
Inclusion Criteria
  • Subjects who are undergoing SCR for massive rotator cuff
  • Adult patients (≥18)
  • Pre-operative MRI obtained within 26 weeks prior to surgery
  • Must have 3 out of 5 external rotation strength
  • Must have intact teres minor
Exclusion Criteria
  • Worker's Compensation Case
  • Persons with a mental or cognitive disability deemed significant enough that they would not be capable of complying with a restricted rehabilitation program or completing the outcome measures
  • Patients with known contraindications to MRI
  • Pectoralis major, pectoralis minor, deltoid, or latissimus dorsi dysfunction
  • Acute fractures of humerus, clavicle, scapula
  • Inability to speak and/or understand English

Intra-Op Exclusion Criteria:

  • Anterosuperior escape of the glenohumeral joint due to a completely incompetent anterosuperior cuff and coracoacromial ligament (CAL)
  • Unable to fix the graft on the humeral side utilizing a double row repair
  • Inability to address subscapularis pathology
  • Diffuse bipolar cartilage loss

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Acromiohumeral interval change24 months

Xrays will be used to compare the amount of superior humeral migration between 12 month xrays and 24 month xrays

Rotator Cuff Integrity and Graft Incorporation24 months

These will be assessed via MRI with Arthrogram- changes will be compared between the 12 and 24 month time points

Clinical FailureWithin 24 months

Revision Surgery

Secondary Outcome Measures
NameTimeMethod
Shoulder Pain24 months

Pain will be assessed on a Visual Analog Scale (VAS) (0-10; where 0 is no pain and 10 is the worst pain imaginable)

Range of Motion24 months

Function will be assessed by measuring active range of motion (forward flexion, abduction, external rotation, internal rotation) with a goniometer

Function (Activities of Daily Living)24 months

Function will be assessed via the American Shoulder and Elbow Score (0-100; higher score is better)

Resilience24 months

Resilience will be assessed via the Brief Resilience Score (BRS) (scores 1-5; higher score = higher resilience)

Function (Overall Normal rating)24 months

Function will be assessed via the Single Assesment Numeric Evaluation (SANE) (0-100; where 100 is normal)

Trial Locations

Locations (1)

Western Orthopaedics Education and Research Foundation

🇺🇸

Denver, Colorado, United States

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