We aim to clinically establish that the subscapularis is crucial for glenohumeral stability in two work packages. In work package 1, we will test the hypotheses that at baseline patients with degenerative subscapularis tears: 1) advocate…
ID
Source
Brief title
Condition
- Tendon, ligament and cartilage disorders
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
1) muscle activation assessed with electromyography and expressed as activation
ratios of the deltoid muscle, latissimus dorsi, pectoralis major and teres
major,
Secondary outcome
2) external rotation in 90 * humeral elevation in the coronal plane with elbow
flexed in 90 * (electromagnetic tracking device), 3) clinical outcome (medical
history, clinical examination, VAS (pain), CS, WORC, SF-12, three anchor
questions, RC-muscle quality MRA).
Background summary
A frequent cause of shoulder complaints are degenerative rotator cuff (RC)
tears. The supraspinatus is most often involved, but only in case of
infraspinatus and/or subscapularis involvement, symptoms severely increase. As
opposed to degenerative infraspinatus tears, literature on degenerative
subscapularis tears, is scarce. Cadaver and computational biomechanical studies
have proved that the subscapularis is crucial for glenohumeral stability and
thereby proper shoulder function. Remarkably, in both clinics and in research,
dysfunction of the subscapularis is commonly not addressed. This may represent
a large gap in our knowledge and a limitation of current care.
Study objective
We aim to clinically establish that the subscapularis is crucial for
glenohumeral stability in two work packages. In work package 1, we will test
the hypotheses that at baseline patients with degenerative subscapularis tears:
1) advocate compensatory muscle antagonistic activation of the teres major and
latissimus dorsi during abduction, and 2) have decreased external rotation and
arm elevation, compared to asymptomatic controls without RC-tears. Second, in
work package 2, we will test the hypothesis that after surgery, complaints
decrease and there is less need for compensatory biomechanics and thus,
kinematics and muscle activation patterns restore towards biomechanics in
asymptomatic controls.
Study design
A cohort study with assessment of shoulder kinematics, muscle activation
patterns, and clinical outcome. Evaluations are pre-operative and at 6 and 12
months postoperative.
Study burden and risks
Participants are asked to complete questionnaires and to undergo biomechanical
measurements, which will take 80-95 minutes per session.
Albinusdreef 2
Leiden 2333 ZA
NL
Albinusdreef 2
Leiden 2333 ZA
NL
Listed location countries
Age
Inclusion criteria
Patients diagnosed with a degenerative subscapularis tear (i.e. involvement of
the supraspinatus and subscapularis) based on clinical examination (i.e.
positive lift-off or belly press test) and confirmed by Magnetic Resonance
Arthrography (MRA), who are planned to undergo an open subscapularis tendon
repair. Patients are also included in case of additional infraspinatus
involvement (i.e. not a reason to exclude a patient).
Exclusion criteria
- Younger than 18 years of age
- Isolated subscapularis tears (e.g. traumatic)
- Teres minor tear
- Radiographic osteoarthritis of the glenohumeral joint of Kellgren Lawrence >
grade 2 and/or acromioclavicular joint and/or sternoclavicular joint
- History of fractures or dislocations of the shoulder
- Contraindications for surgery
- Tumours
- Insufficient Dutch language skills
- No informed consent
- Electronic implants (e.g. ICD, pacemakers)
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL63384.058.17 |