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TerminatedNCT04887337PROMPTUpdated Nov 26, 2025

Early arthroscoPic Stabilization veRsus rehabilitatiOn of the Shoulder in Adolescents With a trauMatic First-time Anterior Shoulder Dislocation ePisode

An interventional study of Arthroscopic stabilization and Rehabilitation including a period of immobilization followed by physical therapy in Shoulder Dislocation, sponsored by McMaster University. Terminated at 1 site in Canada. Open to participants aged 12 Years to 18 Years. Per ClinicalTrials.gov, last updated 2025-11-26.

Sponsored by McMaster University · Not applicable, Interventional, and Treatment

Why this study was terminated
Poor recruitment
Phase
Not applicable
Study type
Interventional
Enrollment
2
Allocation
Randomized
Ages
12 Years to 18 Years
Sex
All
01

Study summary

Each year within Canada and the US, more than 30,000 children and adolescents will have an injury to their shoulder resulting in a shoulder dislocation. Although the current practice is to manage this initial dislocation without surgery, the vast majority of these children and adolescents will, unfortunately continue to have instability episodes of their shoulder. Recurrent instability can cause damage to the bones and cartilage that form the shoulder resulting in potentially more difficult surgical stabilization, and possibly long-term sequela. To that effect, there is increasing interest to consider early surgical stabilization in this population. This pilot randomized controlled trial (RCT) will evaluate the feasibility of conducting a larger RCT assessing the effect of early arthroscopic stabilization compared to rehabilitation on the rate of repeat shoulder dislocations (recurrent instability), pain, and shoulder function among adolescents (aged 12-18 years) with first-time shoulder dislocations. These patients will be followed for one year.

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Conditions studied

  • Shoulder Dislocation

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03

Who can participate

Ages eligible
12 Years to 18 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  1. Males and females between the ages of 12 and 18, inclusive
  2. Patients with a first-time traumatic anterior glenohumeral dislocation within the past 3 months
  3. Anterior glenohumeral dislocation confirmed by radiography, reduction required by medical personnel, or demonstration of anterior apprehension on physical examination following injury to the shoulder
  4. MRI or MRA demonstrating disruption of the glenohumeral soft tissues (including the labrum, periosteum, or inferior glenohumeral ligament) relating to instability
  5. Patients who have the ability to speak, understand, and read English
  6. Provision of informed consent (age 18) or parental consent (ages 12-17, inclusive)
  7. Provision of informed child assent (ages 12-17, inclusive)

Exclusion criteria

Exclusion Criteria:

  1. Previous dislocation episodes or instability of the affected shoulder
  2. Previous surgeries involving the affected shoulder
  3. History or clinical exam findings of generalized ligamentous laxity (defined as a Beighton score of 4 or more points)
  4. History of multi-directional instability of either shoulder
  5. Concomitant fracture of the tuberosity, humerus, or glenoid (excluding a Bankart or Hill Sachs lesion)
  6. Bony Bankart lesion exceeding 15% of the glenoid surface (using the best-fit circle method on MRI)
  7. Hill Sachs lesion exceeding 15% of the humeral diameter (Measured on transaxial slice of MRI similar to Salomonsson et al.)
  8. A neurological injury of the affected arm
  9. Patients who will likely have problems, in the judgement of the investigator, with maintaining follow-up
  10. Any other reason(s) the investigator feels is relevant for excluding the patient
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Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
2 participants (actual)

Study arms

  • Active comparator
    Arthroscopic stabilization

    Patients will have an initial evaluation with a diagnostic shoulder arthroscopy and examination under anesthesia will be performed to confirm the degree of anterior instability and assess range of motion of the affected shoulder. Diagnostic arthroscopy will commence with the use of 3 standard shoulder portals (posterior viewing and two anterior working portals for suture passing), and a detailed arthroscopic examination will be performed. Once the soft tissue tear (including the labrum, and capsule labrum ligaments) is identified, it will be mobilized using a rasp or elevator and a burr will then be used to create a surface for a bleeding bone bed. Capsulolabral repair will then commence with the labrum fixed to the glenoid using suture anchors (the Bankart repair). Following surgery, subjects in this group will follow the same rehabilitation protocol as the comparison group.

    Procedure: Arthroscopic stabilization

  • Active comparator
    Rehabilitation including a period of immobilization followed by physical therapy

    Subjects in this group will use an internal-rotation shoulder immobilizer, using a standard sling for 6 weeks from the day of enrollment. Subjects will be advised to maintain range of motion (ROM) in the elbow and wrist during this period of time. The immobilizer can be removed for passive pendulum exercises and elbow ROM during the period of immobilization up to 4 times per day. Formal physiotherapy commences at 4 weeks post-enrollment, with a goal of return to activities or sport at 6-months post-enrollment.

    Other: Rehabilitation including a period of immobilization followed by physical therapy

Interventions

  • ProcedureArthroscopic stabilization

    Early arthroscopic stabilization with Bankart repair

  • OtherRehabilitation including a period of immobilization followed by physical therapy

    Rehabilitation including a period of immobilization followed by physical therapy

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What researchers measure

Primary outcomes

  1. Rate of recurrent shoulder dislocation

    Recurrent shoulder dislocations will be defined as an episode of repeat anterior shoulder dislocation either requiring reduction by medical personnel, an x-ray confirming anterior dislocation of the shoulder, or the requirement of surgical management of recurrent instability.

    Time frame: 12 months

Secondary outcomes

  1. Visual Analogue Scale

    100-point pain scale, range 0-100, higher score indicates worse pain.

    Time frame: 12 months

  2. Pediatric and Adolescent Shoulder and Elbow Survey

    The Pediatric and Adolescent Shoulder and Elbow Survey has recently been adopted as a shoulder and elbow function scale designed specifically for children and adolescents aged 10-18, and has shown to be well received and understood in this age group. The total score - 100 maximum points - is weighted 50% for pain and 50% for function.

    Time frame: 12 months

  3. Euro-Qol 5 Dimensions Youth

    The Euro-Qol 5 Dimensions Youth comprises 5 dimensions of health (mobility, self-care \[looking after myself\], usual activities, pain/discomfort, and anxiety/depression \[feeling worried, sad or unhappy\]). Score range 0-100, higher score indicating worse outcomes.

    Time frame: 12 months

  4. Rate of adverse events (other than recurrent shoulder dislocations)

    Defined as any symptom, sign, illness, or experience that develops or worsens in severity during the course of this study.

    Time frame: 12 months

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Study locations

1 site
  • McMaster University
    Hamilton, Ontario L8N 3Z5, Canada
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References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

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Registry details

Key details

Study ID
NCT04887337
Lead sponsor
McMaster University
Responsible party
Sponsor
First posted
May 14, 2021
Start date
Sep 19, 2022
Primary completion
Oct 24, 2025
Completion
Oct 24, 2025
Last update
Nov 26, 2025

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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