NCT04697004

Brief Summary

The SMR Stemless Reverse is intended for total, primary shoulder joint replacement by reducing pain and restoring shoulder articular mobility function. This is a prospective, multi-center, randomized, controlled trial to demonstrate non-inferiority of the SMR Stemless Reverse to the SMR Reverse Shoulder System. Patients with joint dysfunction who continue to experience significant symptoms despite an appropriate course of non-operative management are eligible. Patients will be considered enrolled into the study when an ICF has been signed, all inclusion criteria are met and no exclusion criteria are present including intraoperative exclusion criteria, and the patient is randomized into either the SMR Stemless Reverse (investigational) group, the SMR Reverse Shoulder System (control) group or is part of the roll-in population. Enrollment is expected to take approximately 24 months.

Trial Health

57
Monitor

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
200

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started Apr 2021

Longer than P75 for not_applicable

Geographic Reach
1 country

11 active sites

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

January 4, 2021

Completed
2 days until next milestone

First Posted

Study publicly available on registry

January 6, 2021

Completed
3 months until next milestone

Study Start

First participant enrolled

April 1, 2021

Completed
5 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

March 30, 2026

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

March 30, 2026

Completed
Last Updated

October 2, 2024

Status Verified

October 1, 2023

Enrollment Period

5 years

First QC Date

January 4, 2021

Last Update Submit

October 1, 2024

Conditions

Keywords

Shoulder JointShoulder ReplacementArthritis with rotator cuff tearPost traumatic fracture sequeleSevere osteoarthritis and rotator cuff deficiencySignificant glenoid or socket side bone deformed or lossReoccurrence of instability or chronic shoulder dislocationSevere osteoarthritis and stiff shoulder

Outcome Measures

Primary Outcomes (2)

  • Primary Efficacy Endpoint-Constant Murley Score

    The primary efficacy endpoint is to assess successful clinical outcomes by Constant-Murley Score (CMS) adjusted for gender and age at month 24 defined as an increase in CMS of at least 15 points over baseline CMS. The Constant-Murley score (CMS) is a 100-points scale composed of a number of individual parameters. These parameters define the level of pain and the ability to carry out the normal daily activities of the patient. The higher the score, the higher the quality of the function.

    24 Months

  • Primary Safety Endpoint-Absence of revisions, reoperations, and implant loosening.

    * Revisions - A revision is a procedure that adjusts, modifies, or removes part of the original implant configuration, with or without replacement of a component. This may include removing a component of a joint implant. * Reoperations - A reoperation is any surgical procedure involving the repaired shoulder that does not include removal, modification, or addition of any components to the investigational device (e.g., drainage of a hematoma at the surgical site). Radiographic: Implant Loosening * A humeral component is considered to be at risk for loosening when a radiolucent line \>2 mm is present in four (4) or more of the eight (8) zones or if there is conclusive evidence of migration or tilt of the component. * A glenoid component is considered to be at risk for loosening in case of conclusive evidence of a migration or tilt of the component or in presence of a circumferential radiolucent line of at least 2 mm around the glenoid component.

    24 Months

Secondary Outcomes (9)

  • Secondary Efficacy Measure-Constant-Murley Score

    3, 6, and 12 month visits

  • Secondary Efficacy Measure-American Shoulder and Elbow Surgeons Shoulder Score (ASES)

    3, 6, 12 and 24 month visits

  • Secondary Efficacy Measure-Simple Shoulder Test (SST)

    3, 6, 12 and 24 month visits

  • Secondary Efficacy Measure-EQ-5D-5L

    3, 6, 12 and 24 month visits

  • Secondary Efficacy Measure-Range of Motion (ROM)

    3, 6, 12 and 24 month visits

  • +4 more secondary outcomes

Study Arms (2)

SMR Stemless Reverse

EXPERIMENTAL
Device: Investigational Arm: SMR Stemless Reverse

SMR Reverse Shoulder System

ACTIVE COMPARATOR
Device: Control Arm: SMR Reverse Shoulder System

Interventions

The SMR Stemless Reverse is intended for total, primary shoulder joint replacement by reducing pain and restoring shoulder articular mobility function.

SMR Stemless Reverse

Conventional stemmed shoulder prostheses are commonly used in the clinical practice.

SMR Reverse Shoulder System

Eligibility Criteria

Age22 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Age ≥ 22 years of age
  • Skeletally mature as evident by scapula and proximal humerus closure
  • Candidate for primary total shoulder replacement in a grossly rotator cuff deficient joint with severe arthropathy (disabled shoulder), when clinical indications based on physical exam and medical history including one or more of the following:
  • Arthritis with rotator cuff tear not reparable
  • Irreparable rotator cuff tear
  • Rotator cuff tear arthropathy
  • Severe osteoarthritis and rotator cuff deficiency or stiff shoulder
  • Significant glenoid or socket side bone deformed or loss
  • Reoccurrence of instability or a chronic shoulder dislocation
  • Any other medical reason that the investigator determine that subject is a good candidate for a reverse total shoulder arthroplasty

You may not qualify if:

  • BMI \> 40 kg/m2
  • Previous contralateral shoulder surgery within 3 months of enrollment or that requires active treatment (i.e. surgery or brace)
  • Had surgery in the targeted shoulder within last 12 months of enrollment, except diagnostic arthroscopy without procedures
  • Had surgery in lower limbs (such as hip or knee) within last 6 months of enrollment
  • Corticosteroid injections in the ipsilateral shoulder within 3 months of enrollment
  • Complete deltoid muscle insufficiency
  • Glenoid retroversion great than 25 degrees based off a 2D axial CT scan
  • History of/or signs and/or symptoms of local or systemic infection including but not limited to septicemia; osteomyelitis
  • Neurologically confirmed nerve lesion compromising shoulder joint function
  • Poor meta-epiphyseal bone stock compromising stability of the implant including but not limited to humeral head fracture, iatrogenic glenoid fracture, severe osteoporosis
  • Metabolic disorders which may impair fixation and stability of the implant including but not limited to uncontrolled diabetes mellitus with an HbA1C \> 7.5%
  • Extended bone loss after previous surgery defined as: complete bone loss of greater and lesser tuberosity
  • Meta-epiphyseal bony defect (including large cyst)

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (11)

Cedars-Sinai Kerlan-Jobe Institute

Los Angeles, California, 90045, United States

WITHDRAWN

Western Orthopaedics

Denver, Colorado, 80218, United States

ACTIVE NOT RECRUITING

Levy Shoulder Center

Boca Raton, Florida, 33428, United States

RECRUITING

AdventHealth

Orlando, Florida, 32803, United States

RECRUITING

Rush Orthopaedics

Chicago, Illinois, 60612, United States

RECRUITING

Upstate Orthopedics

East Syracuse, New York, 13057, United States

RECRUITING

Duke University

Durham, North Carolina, 27708, United States

ACTIVE NOT RECRUITING

University of Pennsylvania

Philadelphia, Pennsylvania, 19104, United States

WITHDRAWN

Rothman Orthopaedic

Philadelphia, Pennsylvania, 19107, United States

RECRUITING

Guthrie

Sayre, Pennsylvania, 18840, United States

RECRUITING

University of Texas- Health Science Center

San Antonio, Texas, 78229, United States

RECRUITING

MeSH Terms

Conditions

Osteoarthritis

Condition Hierarchy (Ancestors)

ArthritisJoint DiseasesMusculoskeletal DiseasesRheumatic Diseases

Study Officials

  • Grant Garrigues, M.D.

    Rush Orthopedics

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: The 200 randomized subjects will be randomized 1:1 to SMR Stemless Reverse and SMR Reverse Shoulder System.
Sponsor Type
INDUSTRY
Responsible Party
SPONSOR

Study Record Dates

First Submitted

January 4, 2021

First Posted

January 6, 2021

Study Start

April 1, 2021

Primary Completion

March 30, 2026

Study Completion

March 30, 2026

Last Updated

October 2, 2024

Record last verified: 2023-10

Data Sharing

IPD Sharing
Will not share

Locations