Biomarkers for the Surgical Treatment of Rotator Cuff Tears

Study Overview
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Brief Summary
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Identification of biomarkers that can predict the outcome of the surgical treatment (i.e. the rate of re-rupture) of tears in the rotator cuff tendon.

Detailed Description
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Rotator cuff tears (i.e. structural failure and tissue disruption in at least one of the four muscles and tendons that form the rotator cuff) are extremely common injuries and represent the most common muscle-tendon tear in patients. Repair of rotator cuff tears is usually advocated for painful tears with functional impairment. However, high failure rates of 13-68% have been reported for surgical repair of rotator cuff tears, irrespective of the surgical technique employed. Higher rates of re-rupture are associated with larger tears, increased patient age, and increased fatty degeneration of the cuff muscles. There is no general consensus as to the causes of re-rupture; where mechanical factors, the existing techniques of suturing, and biological factors are considered as the main factors of recurrence.

Official Title
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Biomarkers for the Surgical Treatment of Rotator Cuff Tears

Conditions
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Rotator Cuff Tears

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Full-thickness rotator cuff tear (isolated transmural supraspinatus muscle tear or combined with infraspinatus and subscapularis tears) with fat content <50% (Goutallier stage 0-2), as confirmed by magnetic resonance imaging Acute or chronic ruptures Older than 40 years of age Voluntary participation in this study Written informed consent to participate in this study Exclusion Criteria: Contraindication because of ethical reasons Pregnant or lactating women Intention/wish to become pregnant during the course of this study Unsafe contraception Clinical co-morbidities, such as renal insufficiency, hepatic dysfunction, cardiovascular disease Known or suspected non-adherence to the study protocol Smoker Drug or alcohol addicted Uncapable of following instructions, e.g. because of insufficient proficiency in languages, psychological problems, dementia, etc. Participation in other clinical trials during the duration of this study, as well as 30 d before inclusion in this study Claustrophobia Systemic corticoid steroid therapy

Ages Eligible for Study
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Minimum Age: 40 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Rotator cuff tear<br>Patients which demonstrate a full-thickness tear of the rotator cuff tendon and meet the inclusion criteria. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes from baseline for anatomical and functional characteristics of the ruptured rotator cuff | Patients will undergo a clinical and functional examination which includes the assessment of mobility, pain and abduction force of the affected and healthy shoulder using standardized tests (Constant score, Quick DASH, Quality of Life Score SF-12), the quantification of the volume (cm3) and fat content (Goutallier Stage) of the affected shoulder using magnet resonance imaging. | Before surgery (baseline), 3 months after surgery, 12 months after surgery | 
| Molecular and cellular characteristics of the tissues affected by tears of the rotator cuff | Before the surgery 10 mL of venous blood will be drawn from the patients and processed for the isolation of genomic DNA and the measure of selected single nuclear polymorphisms. Biopsies ( 10 mg) will be collected intra-operatively from the affected muscle, tendon, capsule and synovial liquid and stored at -80°C. Samples will be subjected to the immunohistochemical and biochemical quantification of the content (in arbitrary units) of selected proteins and tissue composition (as % of total volume). | within 1 year after the last surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Correlation between the molecular and cellular characteristics at the point in time of surgery, and the clinical (magnetic resonance imaging) outcomes | The relationship of the molecular and cellular parameters (measured as primary endpoints) of affected muscle with the clinical and functional measures of shoulder function will be investigated using Pearson correlation and mutual information analysis. | within 1 year after the last surgery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Skeletal Muscle, Rotator Cuff Tear, Rotator Cuff Repair, Biomarker, Predictive factors, Tendon, Subacromial Bursa