Osteoarthritis of Shoulder
Conditions
Keywords
shoulder surgery, arthritis, rotator cuff
Brief summary
The purpose of this study is to examine the rotator cuff muscles in your shoulder at one and two year post total shoulder replacement surgery.
Interventions
DIAGNOSTIC_TESTCT scan of the shoulders
studies of both operative and nonoperative shoulders
Sponsors
Milton S. Hershey Medical Center
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
45 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* age \>45yrs * primary diagnosis of osteoarthritis of the shoulder * total shoulder replacement performed by Dr. Armstrong * administered a local anesthetic mixture and not regional anesthesia * all genders * Fluent in written and spoken English * Patients capable of giving informed consent
Exclusion criteria
* Known contraindications to CT/EMG * Inability to provide informed consent * History of recent trauma to the shoulder * Atypical shoulder pain * Other suspected shoulder pathology (i.e. tumor, infection) * Pregnancy * Bilateral total shoulder arthroplasty
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Active Nerve Denervation | one year post surgery | EMG examination will be performed by a single neurologist. The EMG Examination will be performed on the muscles (upper subscapularis, supraspinatus, infraspinatus, teres minor and rhomboid) to look for any presence or absence of active denervation. Presence indicated by increased insertional activity, fibrillation potential, positive sharp waves and/or with fasciculations in both operated and unoperated shoulders. |
| Neuropathic Changes_amplitude | one year post surgery | The EMG Examination will be performed on the muscles (upper subscapularis, supraspinatus, infraspinatus, teres minor and rhomboid) to look for the presence or absence of neuropathic changes assessed by examining unit morphology amplitude: measured in millivolts, in both operated and unoperated shoulders. |
| Neuropathic Changes_recruitment pattern | one year post surgery | The EMG Examination will be performed on the muscles (upper subscapularis, supraspinatus, infraspinatus, teres minor and rhomboid) to look for the presence or absence of neuropathic changes assessed by examining unit morphology: phases with recruitment pattern measured as 1-2 or 3-4 units in both operated and unoperated shoulders. |
| Neuropathic Changes_duration | one year post surgery | The EMG Examination will be performed on the muscles in both operated and unoperated shoulders to look for the presence or absence of neuropathic changes assessed by examining unit morphology: duration measured in milliseconds. |
| Total number of Muscles affected with active denervation | one year post surgery | The EMG Examination will be performed to look for abnormal changes as indicated by presence of active nerve denervation across the 5 muscles (upper subscapularis, Infraspinatus, Supraspinatus, teres minor, Rhomboid) in both operated and unoperated shoulders. |
| Total number of muscles affected with neuropathic changes | one year post surgery | The EMG Examination will be performed to look for neuropathic changes as indicated by amplitude, recruitment pattern and duration across the 5 muscles (upper subscapularis, Infraspinatus, Supraspinatus, teres minor, Rhomboid) in both operated and unoperated shoulders. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Tear in Rotator Cuff Muscles in both shoulders | one year post surgery | CT Scan to evaluate rotator cuff muscles for presence or absence of any tear in operative and non-operative. If tear is present - partial or full. If full, small or (\<1cm), or medium (1-3 cm\_ or Large (3-5 cm) or massive (\>5cm), tendon involved (supraspinatus or infraspinatus or subscapularis). |
| Fatty degeneration in Rotator Cuff Muscles in both shoulders using Goutallier Classification | one year post surgery | CT scan to evaluate atrophy in Rotator Cuff Muscles using the Goutallier Classification System. The Classification system measures fatty tissue infiltration and has five stages, ranging from Stage 0 (normal muscle) to Stage 4 (more fat than muscle) in upper subscapularis, infraspinatus, supraspinatus, teres minor and rhomboid in both operated and unoperated shoulder. |
| Fatty atrophy in Rotator Cuff Muscles in both shoulders | one year post surgery | CT Scan to evaluate fatty degeneration in Rotator Cuff Muscles - present or absent in upper subscapularis, infraspinatus, supraspinatus, teres minor and rhomboid muscles in both operated and unoperated shoulders. |
Countries
United States
Contacts
CONTACTPadmavathi Ponnuru, PhD
PRINCIPAL_INVESTIGATORApril D Armstrong, MD
Milton S. Hershey Medical Center
Outcome results
None listed