Clinical and Radiographic Outcomes in Arthroscopic Cuistow Procedure and Arthroscopic Modified Bristow Procedure

Completed

• Conditions: Shoulder Dislocation
• Interventions: Procedure: Bristow; Procedure: Inlay Bristow

• Registration Number: NCT05146791
• Lead Sponsor: Peking University Third Hospital

Brief Summary

To evaluate the clinical and radiographic outcomes of arthroscopic Chinese Unique Inlay Bristow procedure (Cuistow procedure) and arthroscopic Bristow procedure in treating recurrent anterior shoulder instability.

Detailed Description

Aim: To compare the clinical and radiographic outcomes following the arthroscopic Chinese Unique Inlay Bristow (Cuistow) procedure and the arthroscopic Bristow procedure.

Background: The Cuistow procedure is a modified Bristow surgery in which a Mortise and Tenon structure was added to the contact surface between the coracoid tip and the glenoid. In previous study, patients received Cuistow procedure have satisfying clinical performance and excellent postoperative bone healing rate (96.1%). However, no comparative studies was performed.

Study Design: Retrospective comparative case-cohort study

Methods: Patients who underwent the arthroscopic Cuisotw procedure and modified Bristow procedure between Jan 2017 and Mar 2018 were selected. 70 patients with recurrent anterior shoulder instability were included. Radiological evaluations with 3D CT scan were performed preoperatively, immediately after the operation, and postoperatively at three months and during the final follow-up (more than 2 years). Clinical assessment for a minimum of 24 months including the 10-point visual analog scale for pain and subjective instability, University of California at Los Angeles scoring system (UCLA score), American Shoulder and Elbow Surgeons score (ASES score), ROWE score, Subjective Shoulder Value (SSV) and active range of motion were completed by independent observers and analyzed.

Study Timeline

• Study Start: 2017-01-17
• Primary Completion: 2018-03-20
• Status Verified: 2021-11
• Study Completion: 2021-11-01
• Study First Submitted: 2021-11-23
• Study First Submitted QC: 2021-11-23
• Last Update Submitted: 2021-11-23
• Study First Posted: 2021-12-07
• Last Update Posted: 2021-12-07

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 70

Inclusion Criteria

1. a glenoid defect ≥10% but <25%,
2. participation in high-demand (collision and overhead) sports combined with the presence of a glenoid defect <25% of the glenoid or without defect
3. failure after Bankart repair.

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Exclusion Criteria

1. multidirectional shoulder instability (MDI),
2. uncontrolled epilepsy
3. pathological involvement of other soft tissue such as the long head of the biceps or a rotator cuff tear
4. previous shoulder stability surgery other than Bankart repair
5. Follow-up was less than 2 years or incomplete follow-up data.

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Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Onlay Bristow Group	Bristow	Onlay Bristow procedure
Inlay Bristow Group	Inlay Bristow	Inlay Bristow procedure

Primary Outcome Measures

Name	Time	Method
Bone union rate	2-year postoperatily	Bone healing was observed in 3D-CT. The bone healing rate was obtained by dividing the number of people who achieved bone healing by the total number of people.
ASES score	2-year postoperatively	The ASES score (Michener 2002) is a 10-item measure of shoulder pain and function. Pain is assessed on a 10-cm visual analog scale (VAS) and accounts for 50% of the total score. The remaining 50% of the score is determined by the responses to 10 4-point Likert-scale questions related to physical function.

Secondary Outcome Measures

Name	Time	Method
VAS for pain score	2-year postoperatively	The visual analog scale (VAS) for pain score is the most commonly used to describe pain levels in patients, ranging from 0 to 10, with a higher score indicating more intense pain.
dislocation rate	2-year postoperatively	The dislocation rate was obtained by dividing the number of people who dislocated postopratively by the total number of people.
Active shoulder ranges of motion	2-year postoperatively	internal rotation at the side, and external and internal rotation at 90° of abduction

Trial Locations

Locations (1)

PekingUTH; 🇨🇳 Beijing, Beijing, China