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Bicep TendinitisNCT03529162

A Prospective Study Comparing Suture Anchor and Soft Tissue Pectoralis Major Tendon Techniques for Biceps Tenodesis

A study testing Long head of Biceps Tenodesis in people with Bicep Tendinitis and Biceps; Tenosynovitis, run by St. Louis University at 3 sites in United States.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

This is a prospective randomized controlled trial comparing two common techniques of long head of biceps tendon tenodesis in shoulder surgery. Numerous techniques of biceps tenodesis currently exist and are commonly performed. Read more about this study

Who is it for?
Ages 18 to 100 yearsHealthy volunteers can take part
What is being tested?
Long head of Biceps Tenodesis
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
4 participants
Where
3 sitesUnited States
Study dates
19 Oct 2018to 27 Jan 2020
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 100 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Age 18 - 100 years
  • Able to provide written informed consent
  • Has: (a) partial- or full-thickness rotator cuff tear verified by preoperative magnetic resonance imaging (MRI) and arthroscopy; (b) concomitant biceps lesions (LHBT partial tear>50%, SLAP type II lesion, pulley lesion, or subluxation/dislocation of LHBT) that were diagnosed arthroscopically with concomitant symptoms; and (c) arthroscopic rotator cuff repair.

Who cannot join

  • Any medical illness that adversely impacts the patient's ability to complete the study procedures
  • Isolated glenohumeral pathological conditions
  • Any prior surgery on the same shoulder
  • Complete rupture of the LHBT assessed by MRI or at time of procedure
  • Incomplete repair of the rotator cuff

Trial locations and contacts

3 sites in 1 country.

United States3 sites
  • Saint Louis University

    St Louis, Missouri, 63110

  • SSM Health - Saint Louis University Hospital

    St Louis, Missouri, 63110

  • SSM Health - St. Mary's Hospital

    St Louis, Missouri, 63110

Other trials in United States

About this study

Official title: A Prospective Randomized Study Comparing Suture Anchor and Soft Tissue Pectoralis Major Tendon Techniques for Biceps Tenodesis

This is a prospective randomized controlled trial comparing two common techniques of long head of biceps tendon tenodesis in shoulder surgery. Numerous techniques of biceps tenodesis currently exist and are commonly performed. We will be comparing the tenodesis procedure using a suture anchor device versus a technique where the tendon is simply sutured to the pectoralis major tendon.

Read the detailed description

Biceps tenodesis is a commonly performed procedure in shoulder surgery. In many cases, it is performed in conjunction with a rotator cuff repair. Currently, biceps tenodesis is performed in many different ways depending on surgeon preference. First, the location of the tenodesis can vary, as surgeons may prefer a suprapectoral or subpectoral tenodesis location. In addition, the tenodesis fixation technique can also vary, as surgeons have the option to use a screw or suture anchor to perform the tenodesis. There have been numerous studies comparing these various techniques, including suprapectoral versus subpectoral techniques and screw versus suture anchor techniques. None of these studies have been conclusive, and there continues to be controversy as to the best technique.

The current study will compare two techniques of subpectoral biceps tenodesis. Specifically, we will compare tenodesis using a suture anchor versus a technique where the tendon is simply sutured to the pectoralis major tendon. The latter technique has been previously described and published.

Being tested
Long head of Biceps Tenodesis
Keywords
Biceps Tendinitis, Subpectoral biceps tenodesis, Biceps tendon disorder
Medical subject headings
Tenosynovitis

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Long head of Biceps TenodesisProcedure or surgery

    Patients will be randomized into two different groups to compare biceps tenodesis techniques

Study groups in NCT03529162
Study groupRoleWhat they receive
Suture Anchor Technique (SA)Active comparatorIf randomized to this group, the patient will receive an open subpectoral long head of biceps tenodesis technique whereby the long head of biceps is re-attached to the humerus using an FDA-approved suture anchor (SA) device for the suture anchor technique. The device to be used will be the Mitek Super Quick Anchor.
Receives: Procedure: Long head of Biceps Tenodesis
Pectoralis Major Technique (PMT)Active comparatorIf randomized to this group, the patient will receive an open subpectoral long head of biceps tenodesis technique whereby the long head of biceps is re-attached by suturing the biceps tendon into the pectoralis major tendon.
Receives: Procedure: Long head of Biceps Tenodesis

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in Long Head of the Biceps Tendon Score (LHB)

    The LHB score is a composite endpoint (maximum 100 points) that evaluates 'biceps pain and muscle cramps', 'cosmesis', and 'flexion strength at the elbow'. It is an outcome score specific for biceps tendon pathology. The score range is 0-100, with a higher score representing better function. The values represent the scores at 3 and 6 months, not a change of values from Baseline to 3 and 6 months.

    Measured: This score obtained pre-operatively, and post-operatively at 3 months, 6 months, which are reported.

Secondary outcomes (4)
  1. Change in Visual Analogue Scale (VAS)

    The Visual Analogue Scale (VAS) consists of a straight line with the endpoints defining extreme limits such as 'no pain at all' and 'pain as bad as it could be'. The patient is asked to mark his pain level on the line between the two endpoints. "0" is no pain and "10" is the worst pain. The values represent the scores at 3 and 6 months, not a change of values from Baseline to 3 and 6 months.

    Measured: This score obtained pre-operatively, and post-operatively at 3 months, 6 months, which are reported.

  2. Change in Disabilities of the Arm, Shoulder, and Hand Score (DASH)

    The disabilities of the arm, shoulder and hand (DASH) questionnaire is a self-administered region-specific outcome instrument developed as a measure of self-rated upper-extremity disability and symptoms. The DASH consists mainly of a 30-item disability/symptom scale, scored 0 (no disability) to 100. The values represent the scores at 3 and 6 months, not a change of values from Baseline to 3 and 6 months.

    Measured: This score obtained pre-operatively, and post-operatively at 3 months, 6 months, which are reported.

  3. Change in Single Assessment Numeric Evaluation (SANE)

    The Single Assessment Numeric Evaluation (SANE) is a simple, one-question patient-reported outcome measure (PROM). Scoring is 1 to 100, with 100 being the highest function/no pain score. The values represent the scores at 3 and 6 months, not a change of values from Baseline to 3 and 6 months.

    Measured: This score obtained pre-operatively, and post-operatively at 3 months, 6 months, which are reported.

  4. Change in American Shoulder and Elbow Surgeons (ASES) Shoulder Score

    The American Shoulder and Elbow Surgeons Shoulder Score (ASES) is a mixed outcome reporting measure, applicable for use in all patients with shoulder pathology regardless of their specific diagnosis.

    The ASES score contains a physician-rated and patient-rated section; however, only the pain visual analog scale (VAS) and 10 functional questions are typically used to tabulate the reported ASES score. The total score - 100 maximum points - is weighted 50% for pain and 50% for function. A score of 100 represents a better outcome and a score of 0 represents a worse outcome. The values represent the scores at 3 and 6 months, not a change of values from Baseline to 3 and 6 months.

    Measured: This score obtained pre-operatively, and post-operatively at 3 months, 6 months, which are reported.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted18 May 2018
  2. Study start19 Oct 2018
  3. Primary completion27 Jan 2020
  4. Study completion27 Jan 2020

Why it stopped: COVID-19, followed by PI leaving institution.

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Prospective Randomized Controlled Trial
Masking
None (open label)
Enrolment
4 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03529162
Sponsor's protocol ID
29091
Status last verified
Apr 2021
First submitted
23 Apr 2018
Last updated
29 Apr 2021
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
Yes
Individual data sharing
No

Publications

  • Abbot AE, Li X, Busconi BD. Arthroscopic treatment of concomitant superior labral anterior posterior (SLAP) lesions and rotator cuff tears in patients over the age of 45 years. Am J Sports Med. 2009 Jul;37(7):1358-62. doi: 10.1177/0363546509331940. Epub 2009 Apr 13.

    PubMed 19364887
  • Ahmed M, Young BT, Bledsoe G, Cutuk A, Kaar SG. Biomechanical comparison of long head of biceps tenodesis with interference screw and biceps sling soft tissue techniques. Arthroscopy. 2013 Jul;29(7):1157-63. doi: 10.1016/j.arthro.2013.04.001. Epub 2013 May 29.

    PubMed 23725678
  • Chen CH, Hsu KY, Chen WJ, Shih CH. Incidence and severity of biceps long head tendon lesion in patients with complete rotator cuff tears. J Trauma. 2005 Jun;58(6):1189-93. doi: 10.1097/01.ta.0000170052.84544.34.

    PubMed 15995469
  • Chung SW, Oh JH, Gong HS, Kim JY, Kim SH. Factors affecting rotator cuff healing after arthroscopic repair: osteoporosis as one of the independent risk factors. Am J Sports Med. 2011 Oct;39(10):2099-107. doi: 10.1177/0363546511415659. Epub 2011 Aug 3.

    PubMed 21813440
  • Golish SR, Caldwell PE 3rd, Miller MD, Singanamala N, Ranawat AS, Treme G, Pearson SE, Costic R, Sekiya JK. Interference screw versus suture anchor fixation for subpectoral tenodesis of the proximal biceps tendon: a cadaveric study. Arthroscopy. 2008 Oct;24(10):1103-8. doi: 10.1016/j.arthro.2008.05.005. Epub 2008 Jun 16.

    PubMed 19028161
  • Habermeyer P, Magosch P, Pritsch M, Scheibel MT, Lichtenberg S. Anterosuperior impingement of the shoulder as a result of pulley lesions: a prospective arthroscopic study. J Shoulder Elbow Surg. 2004 Jan-Feb;13(1):5-12. doi: 10.1016/j.jse.2003.09.013.

    PubMed 14735066
  • Hsu AR, Ghodadra NS, Provencher MT, Lewis PB, Bach BR. Biceps tenotomy versus tenodesis: a review of clinical outcomes and biomechanical results. J Shoulder Elbow Surg. 2011 Mar;20(2):326-32. doi: 10.1016/j.jse.2010.08.019. Epub 2010 Nov 4.

    PubMed 21051241
  • Koh KH, Ahn JH, Kim SM, Yoo JC. Treatment of biceps tendon lesions in the setting of rotator cuff tears: prospective cohort study of tenotomy versus tenodesis. Am J Sports Med. 2010 Aug;38(8):1584-90. doi: 10.1177/0363546510364053. Epub 2010 Jun 15.

    PubMed 20551285
  • Oh JH, Kim SH, Ji HM, Jo KH, Bin SW, Gong HS. Prognostic factors affecting anatomic outcome of rotator cuff repair and correlation with functional outcome. Arthroscopy. 2009 Jan;25(1):30-9. doi: 10.1016/j.arthro.2008.08.010. Epub 2008 Oct 10.

    PubMed 19111216
  • Oh JH, Lee YH, Kim SH, Park JS, Seo HJ, Kim W, Park HB. Comparison of Treatments for Superior Labrum-Biceps Complex Lesions With Concomitant Rotator Cuff Repair: A Prospective, Randomized, Comparative Analysis of Debridement, Biceps Tenotomy, and Biceps Tenodesis. Arthroscopy. 2016 Jun;32(6):958-67. doi: 10.1016/j.arthro.2015.11.036. Epub 2016 Feb 23.

    PubMed 26921128
  • Park JS, Kim SH, Jung HJ, Lee YH, Oh JH. A Prospective Randomized Study Comparing the Interference Screw and Suture Anchor Techniques for Biceps Tenodesis. Am J Sports Med. 2017 Feb;45(2):440-448. doi: 10.1177/0363546516667577. Epub 2016 Oct 22.

    PubMed 28146397
  • Pogorzelski J, Horan MP, Hussain ZB, Vap A, Fritz EM, Millett PJ. Subpectoral Biceps Tenodesis for Treatment of Isolated Type II SLAP Lesions in a Young and Active Population. Arthroscopy. 2018 Feb;34(2):371-376. doi: 10.1016/j.arthro.2017.07.021. Epub 2017 Sep 9.

    PubMed 28899638
  • Ramos CH, Coelho JC. Biomechanical evaluation of the long head of the biceps brachii tendon fixed by three techniques: a sheep model. Rev Bras Ortop. 2016 Dec 30;52(1):52-60. doi: 10.1016/j.rboe.2016.12.008. eCollection 2017 Jan-Feb.

    PubMed 28194382
  • Scheibel M, Schroder RJ, Chen J, Bartsch M. Arthroscopic soft tissue tenodesis versus bony fixation anchor tenodesis of the long head of the biceps tendon. Am J Sports Med. 2011 May;39(5):1046-52. doi: 10.1177/0363546510390777. Epub 2011 Jan 21.

    PubMed 21257843
  • Walch G, Edwards TB, Boulahia A, Nove-Josserand L, Neyton L, Szabo I. Arthroscopic tenotomy of the long head of the biceps in the treatment of rotator cuff tears: clinical and radiographic results of 307 cases. J Shoulder Elbow Surg. 2005 May-Jun;14(3):238-46. doi: 10.1016/j.jse.2004.07.008.

    PubMed 15889020

Questions about this trial

What is this clinical trial studying?

A study testing Long head of Biceps Tenodesis in people with Bicep Tendinitis and Biceps; Tenosynovitis, run by St. Louis University at 3 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 29 Apr 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 3 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 29 Apr 2021). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in Long Head of the Biceps Tendon Score (LHB) (time frame: This score obtained pre-operatively, and post-operatively at 3 months, 6 months, which are reported.). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03529162, which also lists 16 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 29 Apr 2021.

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