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Audigé L, Bucher HCC, Aghlmandi S, Stojanov T, Schwappach D, Hunziker S, Candrian C, Cunningham G, Durchholz H, Eid K, Flury M, Jost B, Lädermann A, Moor BK, Moroder P, Rosso C, Schär M, Scheibel M, Spormann C, Suter T, Wieser K, Zumstein M, Müller AM. Swiss-wide multicentre evaluation and prediction of core outcomes in arthroscopic rotator cuff repair: protocol for the ARCR_Pred cohort study. BMJ Open 2021; 11:e045702. [PMID: 33888530 PMCID: PMC8070866 DOI: 10.1136/bmjopen-2020-045702] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 03/20/2021] [Accepted: 03/22/2021] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION In the field of arthroscopic rotator cuff repair (ARCR), reporting standards of published studies differ dramatically, notably concerning adverse events (AEs). In addition, prognostic studies are overall methodologically poor, based on small data sets and explore only limited numbers of influencing factors. We aim to develop prognostic models for individual ARCR patients, primarily for the patient-reported assessment of shoulder function (Oxford Shoulder Score (OSS)) and the occurrence of shoulder stiffness 6 months after surgery. We also aim to evaluate the use of a consensus core event set (CES) for AEs and validate a severity classification for these events, considering the patient's perspective. METHODS AND ANALYSIS A cohort of 970 primary ARCR patients will be prospectively documented from several Swiss and German orthopaedic clinics up to 24 months postoperatively. Patient clinical examinations at 6 and 12 months will include shoulder range of motion and strength (Constant Score). Tendon repair integrity status will be assessed by ultrasound at 12 months. Patient-reported questionnaires at 6, 12 and 24 months will determine functional scores (subjective shoulder value, OSS), anxiety and depression scores, working status, sports activities, and quality of life (European Quality of Life 5 Dimensions 5 Level questionnaire). AEs will be documented according to a CES. Prognostic models will be developed using an internationally supported regression methodology. Multiple prognostic factors, including patient baseline demographics, psychological, socioeconomic and clinical factors, rotator cuff integrity, concomitant local findings, and (post)operative management factors, will be investigated. ETHICS AND DISSEMINATION This project contributes to the development of personalised risk predictions for supporting the surgical decision process in ARCR. The consensus CES may become an international reference for the reporting of complications in clinical studies and registries. Ethical approval was obtained on 1 April 2020 from the lead ethics committee (EKNZ, Basel, Switzerland; ID: 2019-02076). All participants will provide informed written consent before enrolment in the study. TRIAL REGISTRATION NUMBER NCT04321005. PROTOCOL VERSION Version 2 (13 December 2019).
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Affiliation(s)
- Laurent Audigé
- Research and Development, Schulthess Klinik, Zurich, Switzerland
- Orthopaedic Surgery and Traumatology, University Hospital Basel, Basel, Switzerland
- Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, Basel, Switzerland
| | - Heiner C C Bucher
- Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, Basel, Switzerland
| | - Soheila Aghlmandi
- Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, Basel, Switzerland
| | - Thomas Stojanov
- Research and Development, Schulthess Klinik, Zurich, Switzerland
- Orthopaedic Surgery and Traumatology, University Hospital Basel, Basel, Switzerland
- Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, Basel, Switzerland
| | - David Schwappach
- Swiss Patient Safety Foundation, Zurich, Switzerland
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Sabina Hunziker
- Medical Communication/Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
| | - Christian Candrian
- Trauma and Ortho Unit, Ospedale Regionale di Lugano, Lugano, Switzerland
| | - Gregory Cunningham
- Shoulder Center, Hirslanden Clinique La Colline, Geneva, Switzerland
- Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, Geneve, Switzerland
| | | | - Karim Eid
- Clinic for Orthopaedics and Traumatology, Baden Cantonal Hospital, Baden, Switzerland
| | - Matthias Flury
- Center for Orthopaedics and Neurosurgery, In-Motion, Wallisellen, Switzerland
| | - Bernhard Jost
- Clinic for Orthopaedic Surgery and Traumatology of the Musculoskeletal System, Cantonal Hospital of St.Gallen, St Gallen, Switzerland
| | - Alexandre Lädermann
- Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, Geneve, Switzerland
- Division of Orthopaedics and Trauma Surgery, La Tour Hospital, Meyrin, Switzerland
| | - Beat Kaspar Moor
- Service for Orthopaedics and Traumatology of the Musculoskeletal System, Hôpital du Valais - Centre Hospitalier du Valais Romand, Martigny, Switzerland
| | - Philipp Moroder
- Department of Shoulder and Elbow Surgery, Center for Musculoskeletal Surgery, Charitè Medicine University, Berlin, Germany
| | - Claudio Rosso
- Shoulder and Elbow Center, Arthro Medics, Basel, Switzerland
| | - Michael Schär
- Department of Orthopaedic Surgery and Traumatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Markus Scheibel
- Department of Shoulder and Elbow Surgery, Center for Musculoskeletal Surgery, Charitè Medicine University, Berlin, Germany
- Shoulder and Elbow Surgery, Schulthess Klinik, Zurich, Switzerland
| | - Christophe Spormann
- Center for Endoprosthetics and Joint Surgery, Endoclinic, Zürich, Switzerland
| | - Thomas Suter
- Orthopaedic Shoulder and Elbow, Canton Hospital Baselland, Bruderholz, Switzerland
| | - Karl Wieser
- Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Matthias Zumstein
- Shoulder, Elbow and Orthopaedic Sports Medicine, Orthopaedics Sonnenhof, Bern, Switzerland
- Campus SLB, Swiss Institute for Translational and Entrepreneurial Medicine, Stiftung Lindenhof, Bern, Switzerland
| | - Andreas M Müller
- Orthopaedic Surgery and Traumatology, University Hospital Basel, Basel, Switzerland
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