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Effectiveness of Treatments for Massive Rotator Cuff Tears: Mixed Methodology.
Sponsor: Parc de Salut Mar
Summary
The purpose of this study is: 1) to identify relevant treatment outcomes for people with massive rotator cuff tears of the shoulder joint, according to the experience of the affected people, to facilitate treatment shared decision-making during the specialist consultation in Spain; 2) to compare the effectiveness of conservative treatment, arthroscopic decompressive surgery and reverse prosthesis, in terms of patient's relevant outcomes and health-related quality of life.
Official title: Effectiveness of Treatments of Massive Tears in the Shoulder Rotator Cuff, Assessed With Relevant Results for the Patient: A Mixed Methodology Study.
Key Details
Gender
All
Age Range
65 Years - 85 Years
Study Type
OBSERVATIONAL
Enrollment
200
Start Date
2019-03-27
Completion Date
2027-12-31
Last Updated
2025-06-03
Healthy Volunteers
No
Interventions
Conservative treatment
The rehabilitation is based on restoring the balance of the shoulder joint. Aiming to diminish pain and restore function, pain control and inflammation are addressed during the firsts 3-6 weeks. Before week 3, pendulum movements are allowed to initiate mobilization of the shoulder joint. Aiming to gain (almost) complete shoulder joint mobility, a passive and active mobility exercise program is carried out. Lastly, the focus is on muscle reinforcement, performing a series of active exercises with weights or bands to exercise different muscles of the shoulder or the shoulder girdle.
Arthroscopic Decompression Surgery
Arthroscopic decompression surgery of the rotator cuff tear consists of cleaning the subacromial space. The procedures that are sometimes performed to diminish pain may include, removing the inflamed bursa, releasing the long head of the biceps (if injured), or lightly burring the acromion bone under which the tendons slide.
Reverse Prosthesis
The reverse prosthesis consists of shoulder articular joint replacement. The humeral head is sectioned, and, on the scapular side, a metal tray is placed, which is fixed with screws, and a metal half-sphere fixed to the metal tray. On the humeral side, a metal stem with a concave plastic component is placed to articulate with the metal half-sphere, allowing shoulder mobility without the need of rotator cuff muscles.
Pain-Relief Medication
In the reverse prosthesis procedure and arthroscopic decompression surgery, the pain-relief medication plan is a standard regimen for all patients, which can be modified as needed. This plan is based on 50mg of dexketoprofeno, 1g of paracetamol, and 100mg of tramadol.
Reverse Prosthesis Device
In the reverse prosthesis procedure, a Delta III reverse shoulder prosthesis is applied. The original design was developed by Grammont in 1980's, and has 2 components: 1) a metal tray fixed with screws, and a metal half-sphere fixed to the metal tray, and 2) a concave polyethylene component.
Locations (6)
Parc Taulí Hospital Universitari
Sabadell, Barcelona, Spain
Health Services Research Group, IMIM-Hospital del Mar Medical Research Institute
Barcelona, Spain
Hospital del Mar
Barcelona, Spain
Hospital Clínic
Barcelona, Spain
Hospital Universitario Fundación Jiménez Díaz
Madrid, Spain
Hospital Universitario La Paz
Madrid, Spain