Prosthesis Versus Active Exercise Program in Patients With Rotator Cuff Arthropathy Eligible For Reverse Shoulder Arthroplasty: the ReAct Multicenter, Randomized Controlled Trial

What this Trial Is About

Rotator cuff arthropathy is a condition involving large rotator cuff tears combined with shoulder joint damage that causes pain, swelling, and limited movement. Researchers are comparing the effectiveness of reverse shoulder arthroplasty (RSA), a surgical treatment, to a non-surgical 12-week exercise program in patients with this condition who are eligible for unilateral RSA. The goal is to determine if surgery followed by standard rehabilitation leads to better improvements in shoulder function and pain than exercise alone. Participants will be randomly assigned to one of two groups: one will receive reverse total shoulder arthroplasty followed by standard post-surgery rehabilitation, while the other will complete a 12-week exercise program. This exercise program includes one supervised session weekly with a physiotherapist plus two home exercise sessions each week, focusing on shoulder movement and strength. Educational materials about shoulder osteoarthritis and exercise-related pain will also be provided to those in the exercise group. During the study, patients will undergo assessments at the start, 3 months, 12 months, and then at 2, 5, and 10 years after treatment begins. These evaluations include patient-reported outcomes using the Western Ontario Osteoarthritis of the Shoulder index, disability scores, pain scales, and medication use. Safety will be monitored through the recording of adverse events, particularly during the first month after surgery. The total participation period may last up to 10 years, with careful follow-up to measure long-term results.

Prosthesis Versus Active Exercise Program in Patients With Rotator Cuff Arthropathy