RecruitingNot ApplicableNCT05487274

TSA v RSA in Osteoarthritic Shoulders With Greater Than 15 Degrees of Retroversion

Study Evaluating Reverse Versus Anatomic Total Shoulder Arthroplasty in Shoulders With Greater Than 15 Degrees of Retroversion in the Treatment of Osteoarthritis: Protocol


Sponsor

Ottawa Hospital Research Institute

Enrollment

108 participants

Start Date

Aug 9, 2022

Study Type

INTERVENTIONAL

Conditions

Summary

This study will compare total shoulder arthroplasty (TSA) with an augmented glenoid component and reverse shoulder arthroplasty (RSA) procedures, in participants with advanced glenohumeral osteoarthritis aged 65 years and older, who also present with greater than 15 degrees of glenoid retroversion, in the context of a prospective, randomized controlled trial to determine the optimal treatment in this patient population.


Eligibility

Min Age: 65 Years

Inclusion Criteria5

  • Diagnosis of idiopathic shoulder OA.
  • Patients who have failed standard non-surgical management of their shoulder OA who would benefit from a shoulder arthroplasty. Failed medical management will be defined as persistent pain and disability despite adequate standard non-operative management for at least 6 months. Medical management will be defined as: a) The use of drugs including analgesics and nonsteroidal anti-inflammatory drugs, b) Physiotherapy consisting of stretching, strengthening and local modalities (ultrasound, cryotherapy, etc.), c) Activity modification
  • Imaging, and intra-operative findings confirming advanced glenohumeral cartilage loss
  • Patients with a glenoid deficiency and \>15 degrees of glenoid retroversion up to a maximum of 26 degrees of glenoid retroversion (i.e. -15.1, -17, -20…etc.)
  • years of age and older

Exclusion Criteria12

  • Active joint or systemic infection
  • Rotator cuff arthropathy
  • Significant muscle paralysis
  • Charcot's arthropathy
  • Major medical illness (life expectancy less than 1 year or unacceptably high operative risk)
  • Unable to understand the consent form/process
  • Pregnancy
  • Psychiatric illness that precludes informed consent
  • Unwilling to be followed for the duration of the study
  • Retroversion cannot be surgically corrected to within 10 degrees of neutral
  • History of previous shoulder surgery on affected side
  • Rheumatoid arthritis in the affected shoulder

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Interventions

PROCEDURETotal Shoulder Arthroplasty + augmented glenoid component

Replacement of the shoulder joint (ball and socket, or humeral head and glenoid) using prosthetic components. A prosthetic component is also implanted to correct for the amount of bone loss in the shoulder and restore stability.

PROCEDUREReverse Shoulder Arthroplasty

Replacement of the shoulder joint like the TSA, however the orientation of the ball and socket is reversed.


Locations(1)

Ottawa Hospital Research Institute

Ottawa, Ontario, Canada

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NCT05487274


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