Safety Study of Univers® Revers Shoulder Prosthesis
Primary Purpose
Rotator Cuff Tear Arthropathy
Status
Completed
Phase
Not Applicable
Locations
Switzerland
Study Type
Interventional
Intervention
Universe Reverse Prosthesis
Sponsored by
About this trial
This is an interventional treatment trial for Rotator Cuff Tear Arthropathy focused on measuring rotator cuff tear arthropathy, inverse prosthesis, safety, universe reverse
Eligibility Criteria
Inclusion Criteria:
- Patient aged 18 years and over
- Patient with primary omarthrosis or secondary osteoarthritis associated with insufficiency in the centering function of the rotator cuff
and
• Willing and able to give written informed consent to participate in the study including all follow-up examinations
Exclusion Criteria:
- Previous ipsilateral shoulder arthroplasty
- Acute shoulder trauma
- Post-traumatic secondary osteoarthritis
- Rheumatoid arthritis
- General medical contraindication to surgery
- Known hypersensitivity to the materials used
- Tumour / malignoma
- Any disease process that would preclude accurate evaluation (e.g. neuromuscular, psychiatric or metabolic disorder)
- Bacterial infection at the time point of operation
- Recent history of substance abuse
- Legal incompetence
- Pregnancy or
- Participation in any other medical device or medicinal product study within the previous months that could influence the results of the present study
Sites / Locations
- Schulthess Klinik
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
UniverseReverse
Arm Description
Cohort get an universe reverse prosthesis
Outcomes
Primary Outcome Measures
SADE within 2 years po
The primary safety objective is to demonstrate that severe device-related complication (Serious Adverse Device Effect = SADE) occur within 2 years after prosthesis implantation at a rate of less than 2%.
Secondary Outcome Measures
Risk of adverse events intra-operatively, and post-operatively up to 2 years follow-up
As typically one single surgery should be sufficient to treat the patient, all secondary surgical interventions should be revisions due to a complication.
The occurrence and time of revision surgery (implant survival) will be described by Kaplan-Meier curve.
Prosthesis survival at 2, 5 and 10 years
All Patients with a prosthesis revision will be documented along with the date of revision. At each follow up time point the proportion of patients with prosthesis revision will be estimated. Time to prosthesis revision will be examined by survival methods to account for censored data.
Constant (Murley) score (CS)
The Constant (Murley) score is possibly the most commonly used tool for assessment of shoulder function. The physician asks and documents answers to QOL questions (pain and ADL, ability to work, sleep, sports and leisure) and certain clinical parameters (active ROM, abduction strength). The different scales will be summed and normalized to O=worst to 100= best. A German version is available for clinical use. Investigators are obliged to use a spring balance for the force measurements. Only one measurement per patient per assessment will be done.
The Shoulder Pain and Disability Index (SPADI)
The Shoulder Pain and Disability Index (SPADI) is a short, self-administered questionnaire that provides an item scoring by a visual analogue scale (VAS) from 0 (no pain/no difficulty, i.e. best) to 11 (worst pain imaginable/so difficult required help, i.e. worst). Five items assess pain and 8 items disability of the arm (function). The unweighted means of the 5 pain and the 8 function items will be transformed into the scale from 0 (=worst) to 100 (=best) for both scales and are used to determine pain and function scores. The average of these two scores then gives the total SPADI score. A validated German version is available.
Short version of the Disability of the Arm, Shoulder and Hand questionnaire (QuickDASH)
The Disability of the Arm, Shoulder and Hand questionnaire (DASH) is a comprehensive self-administered questionnaire about symptoms and functioning of the entire upper extremity. The DASH enquires about the ability to perform simple and complex activities of daily living (ADL) that are commonly performed with either one or both arms. The total score is derived from the unweighted mean of 30 items, of which at least 27 have to be answered. The QuickDASH is a more efficient version of the DASH outcome measure that appears to retain its measurement properties. It contains eleven items and is similar with regard to scores and properties to the full DASH. A validated full-length German version is available that can be used in the shortened version.
EuroQoL EQ-5D-5L
The EQ-5D is a widely used instrument to measure and value generic health (status). It is based on a descriptive system that defines health in terms of 5 dimensions: Mobility, Self-Care, Usual Activities, Pain/Discomfort, and Anxiety/Depression. The instrument is designed for self-completion, and patients also rate their overall health on the day of the interview on a 0-100 visual analogue scale (EQ-VAS).
Patient satisfaction
In order to obtain an overall assessment of the arthroplasty result, patients will be asked to assess their current state of health in general related to the operated shoulder joint at the follow-up compared to the state before the arthroplasty. This so-called 'transition' question has the possible answers 'much worse', 'slightly worse', 'equal', 'slightly better', and 'much better'. Patients also rate their level of satisfaction, with the help of a numeric rating scale (NRS: 0-10), in terms of how the outcome met up to their preoperative expectations of the arthroplasty. Finally, they will be asked whether - with their current knowledge of the outcome - they would again choose the operation if they found themselves in similar circumstances to those which prevailed preoperatively.
Radiographic Parameters
Three radiographs should be taken at each study visit: AP view in internal and external rotation and axial view. The images will be collected digitally and centralized for latter evaluation by an independent reviewer based on the radiographic assessment CRF developed by the Schulthess clinic, including the following parameters:
Scapular notching
Signs of osteolysis at the glenoid and at the stem
Status of tuberculum majus and minus
Glenoid migration
Glenoid component seating
Stem position
Change of relative position of components
Ectopic bone formation
Cortical bone resorption
Prosthesis breakage
Rotation failure
Luxation of the prosthesis
PE Wear of the metaglene
PE Dissociation
Patient active and passive range of motion (ROM) and shoulder strength
The following active and passive range of motion parameters will be documented:
Abduction
Elevation
External rotation by 0°
External-internal rotation by 90°
Full Information
NCT ID
NCT01778777
First Posted
January 24, 2013
Last Updated
April 15, 2023
Sponsor
Schulthess Klinik
Collaborators
Arthrex, Inc.
1. Study Identification
Unique Protocol Identification Number
NCT01778777
Brief Title
Safety Study of Univers® Revers Shoulder Prosthesis
Official Title
Safety, Function and Quality of Life in Patient With Rotator Cuff Tear Arthropathy Treated With the Univers® Revers Shoulder Prosthesis
Study Type
Interventional
2. Study Status
Record Verification Date
May 2022
Overall Recruitment Status
Completed
Study Start Date
September 1, 2013 (Actual)
Primary Completion Date
June 1, 2019 (Actual)
Study Completion Date
April 15, 2023 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Schulthess Klinik
Collaborators
Arthrex, Inc.
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The primary safety objective is to demonstrate that severe device-related complication (Serious Adverse Device Effect = SADE) occur within 2 years after prosthesis implantation at a rate of less than 2%. Such adverse events include (but are not limited to) revisions due to dislocation or glenoid loosening, septic arthritis and scapular fractures requiring surgical repair.
Detailed Description
Reverse shoulder arthroplasty and its principles are still recognized today as the gold standard for treatment of degenerative arthropathy of the shoulder associated with an irreparable tear of the rotator cuff. The new Arthrex Univers® Revers Shoulder Prosthesis shows a large and narrow range of components, whether it is a stem, cup, spacer, inlay or glenosphere. Adjustment can be done in very small steps to match anatomic and biomechanic needs. The Arthrex Univers Revers Shoulder Prosthesis is the only device up to date that can be configured in two different inclination angles without any limitation in component use.
This multicentre case-series has the goal to evaluate whether patients with rotator cuff tear arthropathy benefit from the Univers® Revers shoulder prosthesis in terms of low complication risk, as well as high function and quality of life.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Rotator Cuff Tear Arthropathy
Keywords
rotator cuff tear arthropathy, inverse prosthesis, safety, universe reverse
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
166 (Actual)
8. Arms, Groups, and Interventions
Arm Title
UniverseReverse
Arm Type
Experimental
Arm Description
Cohort get an universe reverse prosthesis
Intervention Type
Device
Intervention Name(s)
Universe Reverse Prosthesis
Intervention Description
Implantation of an universe reverse prosthesis
Primary Outcome Measure Information:
Title
SADE within 2 years po
Description
The primary safety objective is to demonstrate that severe device-related complication (Serious Adverse Device Effect = SADE) occur within 2 years after prosthesis implantation at a rate of less than 2%.
Time Frame
2 years po
Secondary Outcome Measure Information:
Title
Risk of adverse events intra-operatively, and post-operatively up to 2 years follow-up
Description
As typically one single surgery should be sufficient to treat the patient, all secondary surgical interventions should be revisions due to a complication.
The occurrence and time of revision surgery (implant survival) will be described by Kaplan-Meier curve.
Time Frame
2 years
Title
Prosthesis survival at 2, 5 and 10 years
Description
All Patients with a prosthesis revision will be documented along with the date of revision. At each follow up time point the proportion of patients with prosthesis revision will be estimated. Time to prosthesis revision will be examined by survival methods to account for censored data.
Time Frame
2, 5 and 10 years
Title
Constant (Murley) score (CS)
Description
The Constant (Murley) score is possibly the most commonly used tool for assessment of shoulder function. The physician asks and documents answers to QOL questions (pain and ADL, ability to work, sleep, sports and leisure) and certain clinical parameters (active ROM, abduction strength). The different scales will be summed and normalized to O=worst to 100= best. A German version is available for clinical use. Investigators are obliged to use a spring balance for the force measurements. Only one measurement per patient per assessment will be done.
Time Frame
6mo, 1, 2, 5 and 10 years
Title
The Shoulder Pain and Disability Index (SPADI)
Description
The Shoulder Pain and Disability Index (SPADI) is a short, self-administered questionnaire that provides an item scoring by a visual analogue scale (VAS) from 0 (no pain/no difficulty, i.e. best) to 11 (worst pain imaginable/so difficult required help, i.e. worst). Five items assess pain and 8 items disability of the arm (function). The unweighted means of the 5 pain and the 8 function items will be transformed into the scale from 0 (=worst) to 100 (=best) for both scales and are used to determine pain and function scores. The average of these two scores then gives the total SPADI score. A validated German version is available.
Time Frame
6mo, 1, 2, 5 and 10 years
Title
Short version of the Disability of the Arm, Shoulder and Hand questionnaire (QuickDASH)
Description
The Disability of the Arm, Shoulder and Hand questionnaire (DASH) is a comprehensive self-administered questionnaire about symptoms and functioning of the entire upper extremity. The DASH enquires about the ability to perform simple and complex activities of daily living (ADL) that are commonly performed with either one or both arms. The total score is derived from the unweighted mean of 30 items, of which at least 27 have to be answered. The QuickDASH is a more efficient version of the DASH outcome measure that appears to retain its measurement properties. It contains eleven items and is similar with regard to scores and properties to the full DASH. A validated full-length German version is available that can be used in the shortened version.
Time Frame
6mo, 1, 2, 5 and 10 years
Title
EuroQoL EQ-5D-5L
Description
The EQ-5D is a widely used instrument to measure and value generic health (status). It is based on a descriptive system that defines health in terms of 5 dimensions: Mobility, Self-Care, Usual Activities, Pain/Discomfort, and Anxiety/Depression. The instrument is designed for self-completion, and patients also rate their overall health on the day of the interview on a 0-100 visual analogue scale (EQ-VAS).
Time Frame
6wk, 6mo, 1, 2, 5 and 10 years
Title
Patient satisfaction
Description
In order to obtain an overall assessment of the arthroplasty result, patients will be asked to assess their current state of health in general related to the operated shoulder joint at the follow-up compared to the state before the arthroplasty. This so-called 'transition' question has the possible answers 'much worse', 'slightly worse', 'equal', 'slightly better', and 'much better'. Patients also rate their level of satisfaction, with the help of a numeric rating scale (NRS: 0-10), in terms of how the outcome met up to their preoperative expectations of the arthroplasty. Finally, they will be asked whether - with their current knowledge of the outcome - they would again choose the operation if they found themselves in similar circumstances to those which prevailed preoperatively.
Time Frame
6wk, 6mo, 1, 2, 5 and 10 years
Title
Radiographic Parameters
Description
Three radiographs should be taken at each study visit: AP view in internal and external rotation and axial view. The images will be collected digitally and centralized for latter evaluation by an independent reviewer based on the radiographic assessment CRF developed by the Schulthess clinic, including the following parameters:
Scapular notching
Signs of osteolysis at the glenoid and at the stem
Status of tuberculum majus and minus
Glenoid migration
Glenoid component seating
Stem position
Change of relative position of components
Ectopic bone formation
Cortical bone resorption
Prosthesis breakage
Rotation failure
Luxation of the prosthesis
PE Wear of the metaglene
PE Dissociation
Time Frame
6mo, 1, 2, 5 and 10 years
Title
Patient active and passive range of motion (ROM) and shoulder strength
Description
The following active and passive range of motion parameters will be documented:
Abduction
Elevation
External rotation by 0°
External-internal rotation by 90°
Time Frame
6mo, 1, 2, 5 and 10 years
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Patient aged 18 years and over
Patient with primary omarthrosis or secondary osteoarthritis associated with insufficiency in the centering function of the rotator cuff
and
• Willing and able to give written informed consent to participate in the study including all follow-up examinations
Exclusion Criteria:
Previous ipsilateral shoulder arthroplasty
Acute shoulder trauma
Post-traumatic secondary osteoarthritis
Rheumatoid arthritis
General medical contraindication to surgery
Known hypersensitivity to the materials used
Tumour / malignoma
Any disease process that would preclude accurate evaluation (e.g. neuromuscular, psychiatric or metabolic disorder)
Bacterial infection at the time point of operation
Recent history of substance abuse
Legal incompetence
Pregnancy or
Participation in any other medical device or medicinal product study within the previous months that could influence the results of the present study
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Hans-Kaspar Schwyzer, Dr.
Organizational Affiliation
Schulthess Klinik
Official's Role
Principal Investigator
Facility Information:
Facility Name
Schulthess Klinik
City
Zürich
State/Province
Kanton Zürich
ZIP/Postal Code
8008
Country
Switzerland
12. IPD Sharing Statement
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Safety Study of Univers® Revers Shoulder Prosthesis
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