Cost-Effectiveness of Rotator Cuff Repair Methods
Rotator Cuff Injuries, Shoulder Pain, Shoulder Impingement
About this trial
This is an interventional treatment trial for Rotator Cuff Injuries focused on measuring Rotator Cuff, Rotator Cuff Tear, Rotator Cuff Tendinopathy, Shoulder Arthroscopy, Rotator Cuff Repair, Open Rotator Cuff Repair
Eligibility Criteria
Inclusion Criteria:
- Patients with complete rotator cuff injury, symptomatic, where there was failure or the patient could not support the non-surgical treatment;
- Patients with high-grade partial rotator cuff injury where therapy failed or the patient did not support non-surgical treatment;
- Patients without medical contraindications for surgery;
- Patients with a good understanding of the Portuguese language and who agree to participate and sign the Informed Consent Form.
Exclusion Criteria:
- Patients under 18 years old
- Patients with previous shoulder surgery;
- Patients with limited range of motion of the shoulder (joint stiffness);
- Patients with previous fractures in the affected shoulder;
- Patients with signs of glenohumeral osteoarthritis;
- Patients with neurological injury;
- Patients who opt not to participate and/or are not willing to sign the informed consent form;
- Patients unable to complete the follow-up evaluation (inability to read or complete the forms).
Sites / Locations
- Hospital Alvorada MoemaRecruiting
- Hospital Israelita Albert Einstein (HIAE)
Arms of the Study
Arm 1
Arm 2
Active Comparator
Active Comparator
Open rotator cuff repair
Arthroscopic rotator cuff repair
Patients will be positioned in a beach chair position with the affected limb pending off the table, allowing manipulation and full range of motion range. After asepsis, antisepsis and placement of sterile surgical fields, anterolateral incision will be made in the shoulder in question; the deltoid muscle belly will be gently divided along its fibers until exposure of the subdeltoid / subacromial bursa, which will be partially excised for exposure of the subacromial space and rotator cuff tendons. After mobilization and release of the ruptured tendons and debridement of the rotator cuff footprint, the tendon repair to the bone will be performed using 5.5m metal anchors, according to the preference and technique chosen by the surgeon. In all cases, the release of the coracoacromial ligament and acromioplasty will be performed.
The patients will be positioned in lateral decubitus position, with the arm to be operated attached to a skin traction device, which trough a traction post and 07 kg, will maintain the shoulder in the following position: abduction of 30 to 60 and flexion of 20 to 30 degrees. After asepsis, antisepsis and placement of impermeable sterile surgical fields, a posterolateral incision will be made in the shoulder for optic introduction, with a 50 mmHg pressure pump and a 0.90 flow, and inspection of the GU joint. After joint inspection, the optic will be introduced into the subacromial space with detachment of the subacromial and subdeltoid. Using shaver blades, partial bursectomy will be performed as well as debridement of the rotator cuff footprint. The tendon will then be reinserted to the bone using metallic 5.5mm anchors. After tendon repair, the coracoacromomial ligament will be released, as well as acromioplasty.