Clinical trial NCT02776345: Ultrasound Guided Interventions of Calcific Tendonitis of Rotator Cuff (SUCTION)
Official title: Study to Evaluate Ultrasound Guided Interventions of Calcific Tendonitis of Rotator Cuff- International CollabratioN (SUCTION)
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: NA
Conditions: Rotator Cuff Calcific Tendonitis
Keywords: calcific tendonitis
rotator cuff calcific tendonitis
Lead sponsor: Hamilton Health Sciences Corporation
Sponsor class: OTHER
Collaborators: name: Post Graduate Institute of Medical Education and Research, Chandigarh
First posted: 2016-05-18
Enrollment: 160
Sex: ALL
Minimum age (years): 18
Maximum age (years): 60
Standard ages: ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The purpose of this study is to determine whether minimally invasive treatments like ultrasound guided needle fragmentation with and without lavage is associated with better clinical outcomes compared to the subacromial bursal corticosteroid injection treatment only.

Detailed description: The objectives of this study are to compare the clinical outcomes of the three treatment arms: ultrasound guided needle fragmentation with lavage, ultrasound guided needle fragmentation without lavage, and subacromial bursal corticosteroid injection treatment. The study design is a randomized control trial.

Eligibility criteria: Inclusion Criteria:

1. Adult men or women ages 18 to 60 years
2. Shoulder pain ( including impingement pain) and reduced range of shoulder movement for greater than 6 months with no relief from non-operative means (physiotherapy, nonsteroidal anti-inflammatory medication, rest).
3. Documentation of failed physiotherapy and conservative management.
4. Calcific tendonitis as diagnosed on ultrasound.
5. Informed consent from participant.
6. Ability to speak, understand and read in the language of the clinical site.

Exclusion Criteria:

1. Previous inclusion in a study involving calcific tendonitis of the rotator cuff
2. Evidence of a calcification in any of the rotator cuff tendons except the supraspinatus tendon.
3. Presence of a tear of the rotator cuff.
4. The supraspinatus tendon calcification is more than 1.5 cm is its largest dimension.
5. Concomitant clinical or MRI diagnosis of frozen shoulder.
6. Previous rotator cuff or shoulder surgery.
7. Those on blood thinners.
8. Those with allergies to medication used.
9. Those with a skin infection at the site of needle entry.
10. Immunosuppressive medication use.
11. Chronic pain syndromes.
12. Significant medical co-morbidities (requiring daily assistance).
13. Ongoing litigation or compensation claims secondary to shoulder problems.
14. Age below 18 years and above 60 years.
15. Any other reasons given to exclude the patient.

Primary outcomes:
measure: Decrease in Pain as measured by the Visual analog scale from 1-10
timeFrame: 8 months
measure: Decreased Range of Motion in the shoulder measured in degrees
timeFrame: 8 months
Secondary outcomes:
measure: Complications and co existing conditions not detected prior to the procedure
timeFrame: Post ultrasound guided procedure through completion of study, up to one year
measure: Costs and health resource utilization as measured by administrative and billing data related to treatment
timeFrame: Up to 8-12 months post surgery
measure: Generic physical and mental health as measured by EuroQol
timeFrame: Up to 8-12 months post surgery
measure: The ultrasound appearance of the targeted calcification
timeFrame: Up to 8-12 months post surgery
Other outcomes:
Locations:
city: Hamilton
country: Canada
facility: Hamilton General Hospital
state: Ontario
Study officials:
affiliation: Hamilton Health Sciences Corporation
name: Hema N Choudur, MBBS
role: PRINCIPAL_INVESTIGATOR
References:
citation: Fusaro I, Orsini S, Diani S, Saffioti G, Zaccarelli L, Galletti S. Functional results in calcific tendinitis of the shoulder treated with rehabilitation after ultrasonic-guided approach. Musculoskelet Surg. 2011 Jul;95 Suppl 1:S31-6. doi: 10.1007/s12306-011-0119-6.
citation: Kachewar SG, Kulkarni DS. Calcific tendinitis of the rotator cuff: a review. J Clin Diagn Res. 2013 Jul;7(7):1482-5. doi: 10.7860/JCDR/2013/4473.3180. Epub 2013 Jul 1.
citation: del Cura JL, Torre I, Zabala R, Legorburu A. Sonographically guided percutaneous needle lavage in calcific tendinitis of the shoulder: short- and long-term results. AJR Am J Roentgenol. 2007 Sep;189(3):W128-34. doi: 10.2214/AJR.07.2254.
citation: Yoo JC, Koh KH, Park WH, Park JC, Kim SM, Yoon YC. The outcome of ultrasound-guided needle decompression and steroid injection in calcific tendinitis. J Shoulder Elbow Surg. 2010 Jun;19(4):596-600. doi: 10.1016/j.jse.2009.09.002. Epub 2009 Dec 2.
citation: Aina R, Cardinal E, Bureau NJ, Aubin B, Brassard P. Calcific shoulder tendinitis: treatment with modified US-guided fine-needle technique. Radiology. 2001 Nov;221(2):455-61. doi: 10.1148/radiol.2212000830.
citation: Sconfienza LM, Bandirali M, Serafini G, Lacelli F, Aliprandi A, Di Leo G, Sardanelli F. Rotator cuff calcific tendinitis: does warm saline solution improve the short-term outcome of double-needle US-guided treatment? Radiology. 2012 Feb;262(2):560-6. doi: 10.1148/radiol.11111157. Epub 2011 Dec 5.
citation: Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck-Ytter Y, Alonso-Coello P, Schunemann HJ; GRADE Working Group. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008 Apr 26;336(7650):924-6. doi: 10.1136/bmj.39489.470347.AD.
citation: Cohen J. Weighted kappa: nominal scale agreement with provision for scaled disagreement or partial credit. Psychol Bull. 1968 Oct;70(4):213-20. doi: 10.1037/h0026256. No abstract available.
citation: Viera AJ, Garrett JM. Understanding interobserver agreement: the kappa statistic. Fam Med. 2005 May;37(5):360-3.
citation: Zhu J, Jiang Y, Hu Y, Xing C, Hu B. Evaluating the long-term effect of ultrasound-guided needle puncture without aspiration on calcifying supraspinatus tendinitis. Adv Ther. 2008 Nov;25(11):1229-34. doi: 10.1007/s12325-008-0115-x.
citation: Chiou HJ, Chou YH, Wu JJ, Huang TF, Ma HL, Hsu CC, Chang CY. The role of high-resolution ultrasonography in management of calcific tendonitis of the rotator cuff. Ultrasound Med Biol. 2001 Jun;27(6):735-43. doi: 10.1016/s0301-5629(01)00353-2.
citation: De Zordo T, Ahmad N, Odegaard F, Girtler MT, Jaschke W, Klauser AS, Chhem RK, Romagnoli C. US-guided therapy of calcific tendinopathy: clinical and radiological outcome assessment in shoulder and non-shoulder tendons. Ultraschall Med. 2011 Jan;32 Suppl 1:S117-23. doi: 10.1055/s-0029-1245333. Epub 2010 Apr 22.
citation: Farin PU, Rasanen H, Jaroma H, Harju A. Rotator cuff calcifications: treatment with ultrasound-guided percutaneous needle aspiration and lavage. Skeletal Radiol. 1996 Aug;25(6):551-4. doi: 10.1007/s002560050133.
citation: Oliva F, Via AG, Maffulli N. Physiopathology of intratendinous calcific deposition. BMC Med. 2012 Aug 23;10:95. doi: 10.1186/1741-7015-10-95.
citation: Ogon P, Suedkamp NP, Jaeger M, Izadpanah K, Koestler W, Maier D. Prognostic factors in nonoperative therapy for chronic symptomatic calcific tendinitis of the shoulder. Arthritis Rheum. 2009 Oct;60(10):2978-84. doi: 10.1002/art.24845.
citation: Vignesh KN, McDowall A, Simunovic N, Bhandari M, Choudur HN. Efficacy of ultrasound-guided percutaneous needle treatment of calcific tendinitis. AJR Am J Roentgenol. 2015 Jan;204(1):148-52. doi: 10.2214/AJR.13.11935.
citation: Speed CA, Hazleman BL. Calcific tendinitis of the shoulder. N Engl J Med. 1999 May 20;340(20):1582-4. doi: 10.1056/NEJM199905203402011. No abstract available.
citation: Serafini G, Sconfienza LM, Lacelli F, Silvestri E, Aliprandi A, Sardanelli F. Rotator cuff calcific tendonitis: short-term and 10-year outcomes after two-needle us-guided percutaneous treatment--nonrandomized controlled trial. Radiology. 2009 Jul;252(1):157-64. doi: 10.1148/radiol.2521081816.