Operative Versus Non-Operative Treatment for Atraumatic Rotator Cuff Tears

Purpose

Rotator cuff tears are one of the most common reasons to seek musculoskeletal care in the United States and one of the fastest growing ambulatory surgery procedures. However, data on comparison of operative versus non-operative treatment is lacking and urgently needed.

Condition

  • Rotator Cuff Tear

Eligibility

Eligible Ages
Between 40 Years and 84 Years
Eligible Genders
All
Accepts Healthy Volunteers
No

Inclusion Criteria

  • Aged =>40 years to <85 years - Shoulder pain and/or loss of range of active motion, strength or function - MRI-confirmed partial- or full-thickness supraspinatus and/or infraspinatus tear of 4cm or less in longitudinal dimension - Medically fit for surgery, defined as Category I-III per American Society of Anesthesiologists (ASA) Physical Status Classification - Ability and willingness to provide informed consent

Exclusion Criteria

  • Primary diagnosis is something other than a rotator cuff tear - History (in last 2 years) of shoulder fracture involving the humeral head on affected side - Previous rotator cuff surgery on affected side - Isolated subscapularis &/or teres minor tear on affected side - Acute rotator cuff tear caused by a severe trauma - Shoulder used as a weight-bearing joint - Contraindication to MRI (claustrophobia, pacemaker, pregnancy, shoulder implant, etc.) - Glenohumeral osteoarthritis on xrays/MRI, as determined by recruiting MD - Grade 4 fatty infiltration of rotator cuff (any tendons) - Candidate for shoulder arthroplasty at baseline - Non-English speaking

Study Design

Phase
N/A
Study Type
Interventional
Allocation
Randomized
Intervention Model
Parallel Assignment
Primary Purpose
Treatment
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Active Comparator
Operative
surgery + post-operative physical therapy
  • Procedure: Operative
    Arthroscopic rotator cuff surgery followed by physical therapy.
  • Procedure: Non-Operative
    Physical therapy (without surgery).
Active Comparator
Non-Operative
non-operative physical therapy
  • Procedure: Non-Operative
    Physical therapy (without surgery).

Recruiting Locations

University of California - San Francisco (UCSF)
San Francisco, California 94158
Contact:
Jocelyn Carpio
415-502-7389
jocelyn.carpio@ucsf.edu

Western Orthopaedics
Denver, Colorado 80218
Contact:
Libby Mauter
303-321-1333
LMauter@Western-Ortho.com

University of Colorado - Denver
Denver, Colorado 80222
Contact:
Andres Barandiaran
303-724-3917
andres.barandiaran@cuanschutz.edu

Johns Hopkins
Baltimore, Maryland 21218
Contact:
Arman Kishan
akishan1@jh.edu

Boston Medical Center
Boston, Massachusetts 02118
Contact:
Jayson Saleet
jsaleet@bu.edu

Beth Israel Deaconess Medical Center
Boston, Massachusetts 02215
Contact:
Katiri Wagner-Nunes, CCRC
617-975-7577
kwagner@bidmc.harvard.edu

University of Michigan
Ann Arbor, Michigan 48106
Contact:
Ryan Mills
734-615-0768
millsrya@med.umich.edu

Washington University
Saint Louis, Missouri 63110
Contact:
Amanda Braun, MA
314-362-3768
haasa@wudosis.wustl.edu

The Ohio State University Wexner Medical Center
Columbus, Ohio 43202
Contact:
Michael Keller
614-293-2410
michael.keller@osumc.edu

Medical University of South Carolina
Charleston, South Carolina 29425
Contact:
Lisa Mock, CCRC
843-876-2211
mockl@musc.edu

Orthopedic Institute
Sioux Falls, South Dakota 57105
Contact:
Khris Loe
888-331-5890
kloe@ortho-i.com

Ortho Tennessee - Knoxville Orthopedic Clinic
Knoxville, Tennessee 37922
Contact:
Grayson Poff
615-772-8819
grayson.poff@orthotennessee.com

Vanderbilt University Medical Center
Nashville, Tennessee 37232
Contact:
Flora Suazo
615-936-8946
flora.m.suazo@vumc.org

University of Texas Southwestern
Dallas, Texas 75390
Contact:
Hemangi Dhole, MPH
214-645-0059
hemangi.dhole@utsouthwestern.edu

Ortho Virginia
Richmond, Virginia 23294
Contact:
Paul Werth
Paul.Werth@orthovirginia.com

More Details

NCT ID
NCT03295994
Status
Recruiting
Sponsor
University of Texas Southwestern Medical Center

Study Contact

Hemangi Dhole, MPH
2146450059
hemangi.dhole@utsouthwestern.edu

Detailed Description

This is non-blinded, randomized controlled trial. Patients will be randomly assigned to either an operative or non-operative course of treatment and will be followed for 12 months from baseline. Aim 1: To compare pain and function in patients undergoing operative versus non-operative treatment of atraumatic rotator cuff tears at 12 months of follow-up Aim 2: To assess effects of rotator cuff tear size and age on comparative outcomes of operative versus non-operative treatments for atraumatic rotator cuff tears