An observational study of the effect of muscle advancement on tendon healing, pain and range of motion in patients undergoing rotator cuff repair for massive tears.

Muscle Advancement and its effect on post-operative tendon healing, pain and range of motion in patients undergoing repair of Massive rotator cuff tears and Arthroscopy: An Observational Case Series

Status

Terminated

Phases

Unknown

Study type

Observational

Source

ANZCTR

Registry ID

ACTRN12620000765921

Acronym

Muscle Advancement and its effect on post-operative tendon healing, pain and range of motion in pati

Enrollment

Registered

2020-07-27

Start date

2020-07-24

Completion date

2023-09-07

Last updated

2025-09-29

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

None listed

Brief summary

Traditionally the failure rate for repair of massive rotator cuff tears has been between 25 and 50%. The aim of this study is to test the hypothesis that adding the technique of muscle advancement to standard rotator cuff repair improves this failure rate along with postoperative shoulder range of motion, pain and function. 50 patients who require surgery for massive rotator cuff tears will undergo repair that includes the addition of the muscle advancement technique. While this will extend their surgery time by around 15 minutes, the rest of their surgery and rehabilitation will proceed as standard. We will use historical age-matched control data extracted from the medical records of patients who have undergone standard surgical repair (ie without muscle advancement) by the study surgeons over the last ten years.

Interventions

50 consecutive patients undergoing surgery for a massive rotator cuff tear will each receive an additional surgical step called muscle advancement. Essentially their shoulder muscle will be detached then advanced (pulled or “slid”) then reattached. This extra step is designed to reduce tension on the surgical site which is one of the proven causes of this type of surgery not being successful. The rest of the surgery and rehabilitation will proceed as usual for rotator cuff repair. The addition of the muscle advancement technique will add approximaetly 15 minutes to the typical rotator cuff surgical time increasing it from (on average) 90 minutes to 105 minutes.To ensure fidelity to the intervention, all 3 surgeons will follow the same technique which will be confirmed using an intraoperative checklist. All 50 patients in this observational study will receive the additional surgical technique. Patients will be observed pre-operatively and assessed in terms of tendon quality (as seen on MRI), pain, range of motion and the function their affected shoulder allows. They will then be assessed post-operatively at 2 weeks (pain only), 8 weeks (pain, range of motion and shoulder function), 24 weeks (pain, range of motion, shoulder function and cuff healing on MRI) and 52 weeks (pain, range of motion and shoulder function).

Eligibility

Sex/Gender

All

Age

18 Years to No maximum

Healthy volunteers

Inclusion criteria

1. Patients who have consented for shoulder arthroscopy and rotator cuff repair under one of the investigators. 2. Patients who are capable of and have given informed consent for their participation in this study.

Exclusion criteria

1. Patients with incomplete rotator cuff tears 2. Patients with isolated subscapularis or supraspinatus tendon tears 3. Patients with a failed rotator cuff repair requiring revision 4. Patients with irreparable rotator cuff tears 5. Patients with acute post trauma rotator cuff tears 6. Patients whose rotator cuff tears have a neurologic lesion such as cervical spondylotic myelopathy 7. Patients with glenohumeral osteoarthritis or rheumatoid arthritis 8. Patients with history of infection in the affected shoulder

Outcome results