Sports Medicine Clinical Trials in Knee and Shoulder Surgery
The UCSF Sports Medicine Group is currently performing many prospective clinical trials focusing on the outcomes of shoulder arthroplasty, rotator cuff tears, shoulder instability, and cartilage injuries.
Shoulder arthritis and replacement
Led by C. Benjamin Ma, MD, the sports group has enrolled over 1,000 patients in a prospective shoulder arthroplasty research study that has successfully published over 30 abstracts and scientific papers. With this database, they have been able to establish important factors that contribute to the outcomes of shoulder replacement including a novel technique to decrease the rate of re-infections after shoulder replacements, and techniques to decrease pain after shoulder replacements. Other studies include evaluation of sleep after shoulder replacement and factors that influence outcomes in shoulder replacement surgery. They are currently evaluating how implant position affects outcomes for reverse shoulder replacement, and how insurance status affects outcomes and follow-up rates.
Cartilage injuries and early arthritis
Cartilage injuries are some of the most common problems facing patients with knee injuries. UCSF has been involved in many clinical national multi-center trials evaluating techniques to improve cartilage health in patients with arthritis (nSTRIDE) under the direction of Brian Feeley, MD, or treat isolated cartilage injuries (NeoCart) under the direction of C. Benjamin Ma, MD. There is currently a new study to test a biologic treatment to treat early knee arthritis that is recruiting patients.
Rotator cuff injuries are the most common injury to the upper extremity. The UCSF sports medicine group is part of a large, multi-center randomized controlled trial evaluating the outcomes of operative and non-operative treatment of rotator cuff tears (ARC Trial). This is a large, multi-center study that will help determine which patients would most benefit from rotator cuff repair, and which patients will benefit from non-operative management. The study is funded by the Patient Centered Outcomes Research Institute (PCORI) and is the largest randomized control trial on rotator cuff injuries in the country.
Beginning in the fall of 2019, the UCSF sports medicine group with Brian Feeley, MD, will begin an exciting clinical trial evaluating a non-invasive technique to improve shoulder surgery outcomes after rotator cuff repair. This study will use a pulsed electromagnetic field to stimulate muscle and tendon growth and regeneration after rotator cuff repair. They have previously shown that pulsed electromagnetic fields (PEMF) allow for differential gene expression, and this may help tendons and muscles regenerate faster after rotator cuff repair. If you are interested in the study, please contact the clinic and schedule an appointment.
Several other prospective clinical trials are currently being performed including studies on patella instability, shoulder dislocations, drug and injection treatments for arthritis, and prehab for shoulder surgery recovery.
1. Grace TR, Khanna K, Choo KJ, Croci R, Feeley BT, Ma CB, Zhang AL. The influence of preoperative opioid use on inpatient opioid requirements and discharge prescriptions after primary shoulder arthroplasty. J Shoulder Elbow Surg. 2018 Apr 24. pii: S1058-2746(18)30173-3. doi: 10.1016/j.jse.2018.02.067. [Epub ahead of print] PubMed PMID: 29703681.
2. Salesky MA, Grace TR, Feeley BT, Ma CB, Zhang AL. Effects of cemented versus press-fit primary humeral stem fixation in the setting of revision shoulder arthroplasty. J Shoulder Elbow Surg. 2018 May;27(5):801-807. doi: 10.1016/j.jse.2017.11.010. Epub 2018 Mar 13. PubMed PMID: 29548544.
3. McLaughlin DC, Cheah JW, Aleshi P, Zhang AL, Ma CB, Feeley BT. Multimodal analgesia decreases opioid consumption after shoulder arthroplasty: a prospective cohort study. J Shoulder Elbow Surg. 2018 Apr;27(4):686-691. doi: 10.1016/j.jse.2017.11.015. Epub 2018 Jan 3. PubMed PMID: 29305103.
4. Wong SE, Pitcher AA, Ding DY, Cashman N, Zhang AL, Ma CB, Feeley BT. The effect of patient gender on outcomes after reverse total shoulder arthroplasty. J Shoulder Elbow Surg. 2017 Nov;26(11):1889-1896. doi: 10.1016/j.jse.2017.07.013. Epub 2017 Sep 11. PubMed PMID: 28911814.
5. Cheah JW, Sing DC, McLaughlin D, Feeley BT, Ma CB, Zhang AL. The perioperative effects of chronic preoperative opioid use on shoulder arthroplasty outcomes. J Shoulder Elbow Surg. 2017 Nov;26(11):1908-1914. doi: 10.1016/j.jse.2017.05.016. Epub 2017 Jul 20. PubMed PMID: 28735841.
6. Aleem AW, Feeley BT, Austin LS, Ma CB, Krupp RJ, Ramsey ML, Getz CL. Effect of Humeral Component Version on Outcomes in Reverse Shoulder Arthroplasty. Orthopedics. 2017 May 1;40(3):179-186. doi: 10.3928/01477447-20170117-04. Epub 2017 Jan 23. PubMed PMID: 28112785.
7. Wong SE, Zhang AL, Berliner JL, Ma CB, Feeley BT. Preoperative patient-reported scores can predict postoperative outcomes after shoulder arthroplasty. J Shoulder Elbow Surg. 2016 Jun;25(6):913-9. doi: 10.1016/j.jse.2016.01.029. Epub 2016 Mar 31. PubMed PMID: 27039669.
8. Zaid MB, Young NM, Pedoia V, Feeley BT, Ma CB, Lansdown DA. Anatomic shoulder parameters and their relationship to the presence of degenerative rotator cuff tears and glenohumeral osteoarthritis: a systematic review and meta-analysis. Shoulder Elbow Surg. 2019 Jul 25. pii: S1058-2746(19)30333-7. doi:10.1016/j.jse.2019.05.008. [Epub ahead of print] Review. PubMed PMID: 31353303.
9. Monroe EJ, Flores SE, Chambers CC, Zhang AL, Feeley BT, Lansdown DA, Ma CB. Patient-Reported Outcomes After Isolated and Combined Arthroscopic Subscapularis Tendon Repairs. Arthroscopy. 2019 Jun;35(6):1779-1784. doi:10.1016/j.arthro.2019.01.034. Epub 2019 May 3. PubMed PMID: 31060759.
10. Tseng WJ, Lansdown DA, Grace T, Zhang AL, Feeley BT, Hung LW, Ma CB. Outcomes of revision arthroplasty for shoulder periprosthetic joint infection: a three-stage revision protocol. J Shoulder Elbow Surg. 2019 Feb;28(2):268-275.doi: 10.1016/j.jse.2018.07.014. Epub 2018 Oct 4. PubMed PMID: 30293858.