defects of the shoulder tendons
Conditions
Interventions
None listed
Sponsors
Onze Lieve Vrouwe Gasthuis
Eligibility
Age
18 Years to 99 Years
Inclusion criteria
Inclusion criteria: Patients can be included if they underwent a LD transfer after massive postero-superior rotator cuff tears (ruptured infra- and supraspinatus) with no osteoarthritis with a minimal follow-up of 1 year.
Exclusion criteria
Exclusion criteria: Patients are excluded from this study in case of severe osteoarthritis of the shoulder or if they underwent any shoulder surgery before the LD transfer in the past.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The following primary study endpoints will be obtained for both the patient group and the control group. With the use of the Flock-of Birds method at the READE Centre, we will measure 3 actively performed ROM tasks: (1) elevation in the sagittal plane (forward flexion), (2) abduction in the scapular plane (elevation), and (3) internal and external rotation of the arm with 90° of abduction in scapular plane (axial rotation). Patients will be instructed to reach a maximal joint angle in each active ROM task. In addition, patients will perform several ADL tasks, such as grasping a cup, combing their hair, and scratching their back. All ROM and ADL tasks will be performed twice, and at the subject*s own pace. For each active ROM task, we will calculate 3 different motions: (1) the motion of the scapula relative to the thorax (ie, scapulothoracic motion), (2) the motion of the humerus relative to the thorax (ie, thoracohumeral motion), and (3) the motion of the humerus to the scapula (ie, glenohumeral motion). All motions are expressed in joint angles defined using the International Society of Biomechanics standardization proposal of the International Shoulder Group. The difference between the thoracohumeral and glenohumeral angles reflects the contribution of scapular motion to the movement of the arm. | — |
Secondary
| Measure | Time frame |
|---|---|
| The following secondary study endpoints will be obtained for both the patient group and the control group: (1) Muscle activity of a selection of shoulder muscles will be recorded with the use of surface EMG (Delsys Trigno Wireless, Delsys Inc., Boston, USA). Muscle activation patterns will be quantified by EMG amplitudes (normalized by 1 kg isometric contractions) and relative timing of different muscles. (2) Abduction and external rotation strength quantified in Newton will be measured with a hand-held dynamometer. The following secondary study endpoints will be obtained for only the patient group: (1) Amount of pain in the shoulder during the 3 actively performed ROM tasks will be noted and quantified according to VAS. (2) All transfers, subscapularis and teres minor muscles will be visualized by MRI imaging. A musculoskeletal radiologist at the OLVG will evaluate these images and assess the degree of atrophy and fatty infiltration according the classification of Goutallier. (3) Ultrasound will be used to (a) assess actual movement of the LD transfer before and after the muscular interval through which the transfer is being pulled, namely between the teres major muscle and the long head muscle of the triceps, and (b) visualize the LD and the subcapularis tendon and assess its integrity and possible ruptures. These observations and classifications will be done by a musculoskeletal radiologist at the OLVG. (4) A standardized X-ray of the operated shoulder will be made at the OLVG and will be classified according the Hamada classification for cuff tear arthropathy by the coordinating and principal investigator. (5) Different shoulder scores and PROMS will be obtained: Constant Scores, Simple Shoulder Test scores, Oxford Shoulder Scores and the DASH. | — |
Countries
Netherlands
Outcome results
None listed