NCT04864158

Brief Summary

Reverse shoulder arthroplasty (RSA) is a well-established treatment for rotator cuff arthropathy. However, the effectiveness of RSA has not been compared to non-surgical treatment in a randomised controlled trial. Shoulder exercises may be an effective treatment for reducing pain and improving function in glenohumeral osteoarthritis. The primary aim of this trial is to examine if RSA followed by standard postsurgical rehabilitation is superior to a 12-week exercise programme in patients with rotator cuff arthropathy eligible for unilateral RSA. The investigators hypothesise that surgical intervention followed by standard rehabilitation, results in clinically relevant (14-point, on a scale from 0-100) improvement compared to the exercise intervention.

Trial Health

80
On Track

Trial Health Score

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

Enrollment
102

participants targeted

Target at P50-P75 for not_applicable

Timeline
152mo left

Started May 2021

Longer than P75 for not_applicable

Geographic Reach
4 countries

8 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

Study Progress28%
May 2021Nov 2038

First Submitted

Initial submission to the registry

April 13, 2021

Completed
15 days until next milestone

First Posted

Study publicly available on registry

April 28, 2021

Completed
1 month until next milestone

Study Start

First participant enrolled

May 28, 2021

Completed
7.4 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

November 1, 2028

Expected
10 years until next milestone

Study Completion

Last participant's last visit for all outcomes

November 1, 2038

Last Updated

April 17, 2025

Status Verified

April 1, 2025

Enrollment Period

7.4 years

First QC Date

April 13, 2021

Last Update Submit

April 14, 2025

Conditions

Keywords

Physiotherapist-supervised ExercisePhysical TherapyPhysical RehabilitationReverse Shoulder ArthroplastyRandomized Controlled TrialCuff Tear Arthropathy

Outcome Measures

Primary Outcomes (1)

  • the Western Ontario Osteoarthritis of the Shoulder index (WOOS)

    WOOS consist of 19 items to be answered using a visual analog scale (VAS). Each item has a possible score ranging from 0 to 100, leading to a total WOOS score ranging from 0 to 1900, with 0 being the best. For simplicity reasons, raw scores can be converted to a percentage of the maximum score (0-100, 100 best).

    Measured at 12 month follow-up

Secondary Outcomes (8)

  • the Western Ontario Osteoarthritis of the Shoulder index (WOOS)

    Measured at baseline, 12-week, 2-, 5- and 10-year follow-up

  • Disabilities of the Arm, Shoulder and Hand (DASH)

    Measured at baseline, 12-week, 12-month, 2-, 5- and 10-year follow-up

  • The change in pain measured on a 100 mm Visual Analogue Scale (VAS)

    Measured at baseline, 12-week, 12-month, 2-, 5- and 10-year follow-up

  • The use of analgesics during the last week

    Measured at baseline, 12-week, 12-month, 2-, 5- and 10-year follow-up

  • The type of analgesics consumed during the last week

    Measured at baseline, 12-week, 12-month, 2-, 5- and 10-year follow-up

  • +3 more secondary outcomes

Other Outcomes (11)

  • Accelerometer-based activity using tri-axial (Axivity, UK) accelerometers

    Measured at baseline and 12-month follow-up

  • Accelerometer-based degree of movement using tri-axial (Axivity, UK) accelerometers

    Measured at baseline and 12-month follow-up

  • The 100 mm Visual Analogue Scale (exercise-group)

    Measured immediately before and immideately after each exercise session. From the date of the start of the exercise intervention until the end of the exercise intervention, assessed up to 12 months.

  • +8 more other outcomes

Study Arms (2)

RSA-group

EXPERIMENTAL

Surgery

Procedure: TSA-group

Exercise-group

EXPERIMENTAL

Exercise

Other: Exercise-group

Interventions

TSA-groupPROCEDURE

Reverse total shoulder arthroplasty followed by standard rehabilitation.

RSA-group

The exercise-group will attend a 12-week exercise program with one weekly physiotherapist-supervised session supplemented with two weekly sessions of home-based exercises. Utilisation of a predefined training protocol describing procedures and content of each session secure uniformity and standardisation of the intervention. The exercise program consists of two warm-up exercises and five exercises that target shoulder range of motion and muscle strength. Furthermore, a link to a video, informing about glenohumeral osteoarthritis, the role of exercise and exercise related pain, will be sent to all patients in the exercise-group. The physiotherapists delivering the exercise intervention are not otherwise related to the trial.

Exercise-group

Eligibility Criteria

Age60 Years - 85 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Patients 60-85 years
  • Eligible for RSA
  • Rotator cuff arthropathy according to Hamada grade 3, 4 and 5 (33)

You may not qualify if:

  • Previous shoulder fracture (fracture of the proximal humerus or glenoid fracture)
  • Planned other upper extremity surgery within six months
  • Rheumatoid arthritis or other types of arthritis not diagnosed as primary glenohumeral OA
  • Cancer diagnosis and receiving chemo-, immuno- or radiotherapy
  • Neurological diseases affecting shoulder mobility (e.g. disability after previous stroke, multiple sclerosis, Parkinson's, Alzheimer's disease)
  • Unable to communicate in the participating countries respective languages

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (8)

Aarhus University Hospital

Aarhus N, Denmark

RECRUITING

Esbjerg Hospital

Esbjerg, 6700, Denmark

RECRUITING

Aalborg University Hospital

Farsø, 9640, Denmark

RECRUITING

Silkeborg Regional Hospital

Silkeborg, 8600, Denmark

RECRUITING

Viborg Regional Hospital

Viborg, 8800, Denmark

RECRUITING

Tartu University Hospital

Tartu, Estonia

RECRUITING

Tampere University Hospital

Tampere, 33521, Finland

RECRUITING

Oslo University Hospital

Oslo, 4956, Norway

RECRUITING

Related Publications (1)

  • Larsen JB, Thillemann TM, Launonen AP, Ostergaard HK, Falstie-Jensen T, Reito A, Jensen SL, Mechlenburg I. Prosthesis versus exercise for rotator cuff tear arthropathy - protocol of a randomised controlled trial. Dan Med J. 2025 Aug 22;72(9):A09240645. doi: 10.61409/A09240645.

MeSH Terms

Conditions

Rotator Cuff Tear Arthropathy

Condition Hierarchy (Ancestors)

ChondrocalcinosisArthritisJoint DiseasesMusculoskeletal DiseasesCrystal Arthropathies

Study Officials

  • Josefine B. Larsen, MSc

    Aarhus University Hospital and Aarhus University

    PRINCIPAL INVESTIGATOR
  • Inger Mechlenburg, Prof.

    Aarhus University Hospital and Aarhus University

    STUDY DIRECTOR
  • Theis M. Thillemann, PhD, As Prof

    Aarhus University Hospital and Aarhus University

    STUDY DIRECTOR
  • Antti P. Launonen, PhD, As Prof

    Tampere University Hospital

    STUDY DIRECTOR

Central Study Contacts

Josefine B. Larsen, MSc

CONTACT

Inger Mechlenburg, Prof.

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
DOUBLE
Who Masked
INVESTIGATOR, OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

April 13, 2021

First Posted

April 28, 2021

Study Start

May 28, 2021

Primary Completion (Estimated)

November 1, 2028

Study Completion (Estimated)

November 1, 2038

Last Updated

April 17, 2025

Record last verified: 2025-04

Data Sharing

IPD Sharing
Will share

Pseudo anonymised patient-level data for the primary and all secondary outcome measures will be made available if required by the scientific journal, in which the results of the trial are published.

Shared Documents
STUDY PROTOCOL, SAP, ICF, ANALYTIC CODE
Time Frame
Data will be available after publication of the trial
Access Criteria
Data access will be reviewed by the author group. Requestors will be required to sign a Data Access Agreement.

Locations