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Trial registered on ANZCTR
Registration number
ACTRN12621000451808p
Ethics application status
Submitted, not yet approved
Date submitted
4/02/2021
Date registered
19/04/2021
Date last updated
19/04/2021
Date data sharing statement initially provided
19/04/2021
Type of registration
Prospectively registered
Titles & IDs
Public title
Reverse Shoulder Arthroplasty with Augments to Restore Joint Line Anatomy in Patients with Glenoid Bone Loss
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Scientific title
Reverse Shoulder Arthroplasty with Augments in Patients with Glenoid Bone Loss (RESHAPING): A Prospective Cohort Study Using Computer Tomography (CT) Scans To Assess Restoration of the Glenohumeral Joint Line Anatomy
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Secondary ID [1]
303352
0
Nil
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Universal Trial Number (UTN)
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Trial acronym
RESHAPING Study
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Glenoid bone loss in patients undergoing reverse shoulder arthroplasty
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Condition category
Condition code
Surgery
318466
318466
0
0
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Other surgery
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Musculoskeletal
319189
319189
0
0
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Osteoarthritis
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
Retrospective review of hospital records will identify patients who have had metallic augment implants used in their reverse shoulder arthroplasty during the study period. These patients will be contacted for enrolment into the study. There are approximately ~20 patients eligible for enrolment, and all of these patients will be offered enrolment into the study.
NB: All patients who have had reverse shoulder arthroplasty will have had a pre-operative CT scan as part of the standard work up prior to their operation. If there are no pre-operative CT scans available, the patient will be excluded from our study. However, not all patients will have post-operative CT scans.
Once patients have been enrolled, all patients will then undergo a post-surgery CT scan with 3D rendering.
The joint line anatomy will measured on both the pre- and post-operative CT scans, and the differences will be compared. We hypothesise that use of metallic augment can successfully achieve restoration of the patient's pre-operative joint line anatomy.
This will be an observational study. The pre- and post-operative joint line anatomy following metallic augment insertion is what we are observing. The participant must undertake a post-operative CT scan and fill in a one-off questionnaire detailing their function and symptoms. We will use externally validated questionnaires e.g. quick disability of the arm, shoulder and hand score (qDASH). The duration of observation is retrospective and dependent on how long ago they had their metallic augment inserted. The time we expect to be able to perform all CT scans is 6 months.
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Intervention code [1]
319665
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Not applicable
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Comparator / control treatment
This is a self-controlled case series.
The patient's joint line anatomy on their pre-operative CT scan is the control group. Following enrolment in the study, they will receive a post-operative CT scan where the joint line anatomy with the metallic augment will be measured, and compared with their pre-operative findings.
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Control group
Active
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Outcomes
Primary outcome [1]
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Glenohumeral joint line position post-surgery based on CT scans (pre and post-operative)
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Assessment method [1]
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Timepoint [1]
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The primary timepoint is dependent on how long ago the patient had their metallic augment implant inserted. This is variable from patient to patient. The timepoint is measured from date of surgery to date of post-operative CT scan. We have excluded all patients within 3 months of their surgery, as we feel this is too soon to provide any meaningful results.
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Secondary outcome [1]
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glenoid version on post-operative CT scan images
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Assessment method [1]
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Timepoint [1]
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The secondary timepoint is dependent on how long ago the patient had their metallic augment implant inserted. This is variable from patient to patient. The timepoint is measured from date of surgery to date of post-operative CT scan. We have excluded all patients within 3 months of their surgery, as we feel this is too soon to provide any meaningful results.
To calculate the secondary timepoint, this will be the date of post-operative CT scan minus the date of surgery. We anticipate the approximate mean secondary timepoint is 1 year after surgery.
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Secondary outcome [2]
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base plate inclination on post-operative CT scan images
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Assessment method [2]
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Timepoint [2]
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The secondary timepoint is dependent on how long ago the patient had their metallic augment implant inserted. This is variable from patient to patient. The timepoint is measured from date of surgery to date of post-operative CT scan. We have excluded all patients within 3 months of their surgery, as we feel this is too soon to provide any meaningful results.
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Secondary outcome [3]
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osseous integration on post-operative CT scan images
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Assessment method [3]
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Timepoint [3]
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The secondary timepoint is dependent on how long ago the patient had their metallic augment implant inserted. This is variable from patient to patient. The timepoint is measured from date of surgery to date of post-operative CT scan. We have excluded all patients within 3 months of their surgery, as we feel this is too soon to provide any meaningful results.
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Secondary outcome [4]
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scapular notching on post-operative CT scan images
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Assessment method [4]
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Timepoint [4]
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The secondary timepoint is dependent on how long ago the patient had their metallic augment implant inserted. This is variable from patient to patient. The timepoint is measured from date of surgery to date of post-operative CT scan. We have excluded all patients within 3 months of their surgery, as we feel this is too soon to provide any meaningful results.
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Secondary outcome [5]
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patient reported outcome measures (PROMs). this will be measured with questionnaires such as the qDASH which the patient will complete at the same time as their CT scan.
The qDASH will look at specifically:
- shoulder pain
- neurological symptoms
- how much symptoms interfere with day to day life
- functionality of upper limb with ability to do day to day activities eg. open jar
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Assessment method [5]
392513
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Timepoint [5]
392513
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The secondary timepoint is dependent on how long ago the patient had their metallic augment implant inserted. This is variable from patient to patient. This particular timepoint is measured from date of surgery to date when patient has completed the PROMs questionnaire e.g. qDASH. We have excluded all patients within 3 months of their surgery, as we feel this is too soon to provide any meaningful results.
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Secondary outcome [6]
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Oxford Shoulder Score
- assess pain and functionality of the shoulder
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Assessment method [6]
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Timepoint [6]
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The secondary timepoint is dependent on how long ago the patient had their metallic augment implant inserted. This is variable from patient to patient. This particular timepoint is measured from date of surgery to date when patient has completed the PROMs questionnaire e.g. qDASH. We have excluded all patients within 3 months of their surgery, as we feel this is too soon to provide any meaningful results.
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Secondary outcome [7]
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pain visual analogue scale score
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Assessment method [7]
394211
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Timepoint [7]
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The secondary timepoint is dependent on how long ago the patient had their metallic augment implant inserted. This is variable from patient to patient. This particular timepoint is measured from date of surgery to date when patient has completed the PROMs questionnaire e.g. qDASH. We have excluded all patients within 3 months of their surgery, as we feel this is too soon to provide any meaningful results.
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Secondary outcome [8]
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goniometer measured shoulder range of motion
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Assessment method [8]
394212
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Timepoint [8]
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The secondary timepoint is dependent on how long ago the patient had their metallic augment implant inserted. This is variable from patient to patient. This particular timepoint is measured from date of surgery to date when patient has completed the PROMs questionnaire e.g. qDASH. We have excluded all patients within 3 months of their surgery, as we feel this is too soon to provide any meaningful results.
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Eligibility
Key inclusion criteria
primary reverse shoulder arthroplasty, metallic augments, patients with glenoid bone loss
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
previous shoulder surgery, concurrent use of bone graft, CT scan follow up less than 3 months from initial surgery
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Study design
Purpose
Natural history
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Duration
Longitudinal
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Selection
Defined population
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Timing
Both
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Statistical methods / analysis
mean and standard deviation calculated for all measurements. inter and intraobserver reliability evaluated using intraclass correlation coefficient
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/05/2021
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Actual
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Date of last participant enrolment
Anticipated
30/06/2021
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Actual
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Date of last data collection
Anticipated
30/06/2021
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Actual
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Sample size
Target
10
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
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New Zealand
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State/province [1]
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Northland
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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Whangarei Hospital
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Address [1]
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Private Bag 9742
Whangarei
New Zealand
0148
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Country [1]
307768
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New Zealand
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Primary sponsor type
Government body
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Name
Northland District Health Board
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Address
Whangarei Hospital
Private Bag 9742
Whangarei
0148
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Country
New Zealand
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Secondary sponsor category [1]
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None
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Name [1]
308471
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Address [1]
308471
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Country [1]
308471
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Ethics approval
Ethics application status
Submitted, not yet approved
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Ethics committee name [1]
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New Zealand Health and Disabilities Ethics Committee
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Ethics committee address [1]
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Ministry of Health Health and Disability Ethics Committees PO Box 5013 Wellington 6140
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Ethics committee country [1]
307791
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New Zealand
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Date submitted for ethics approval [1]
307791
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01/04/2021
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Approval date [1]
307791
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Ethics approval number [1]
307791
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Summary
Brief summary
Glenoid bone loss is a challenging issue when considering reverse shoulder arthroplasty. The glenoid provides bone stock for fixation of the glenosphere, and any bone loss can affect the position and integrity of the implant. In particular, malposition of the implant due to bone loss can affect the glenohumeral joint line anatomy. Overmedialisation and overlateralisation of the joint line both have their own complications which surgeons must try to avoid. Therefore, restoring the anatomic joint line of the patient in reverse shoulder arthroplasty is paramount to the success of the surgery. This study aims to investigate whether use of metallic augments in reverse shoulder arthroplasty implants can restore glenohumeral joint line anatomy. From a single-centred cohort, all patients who have had a primary reverse shoulder arthroplasty and have had pre-operative CT scans will be included in the study. The native joint line will be mapped using 3D reconstruction of the shoulder, and the position of the joint line recorded. Following surgery, post-operative CT scans will be performed and the new joint line anatomy will be measured and compared with pre-operative position. The interval between the two CT scans will vary on the follow up of the patients, but we anticipate a mean follow up period of 2 years. Study Hypothesis: In patients with bone loss, we hypothesise that use of metallic augments in reverse shoulder joint replacement surgery can restore the anatomy of the shoulder joint to how it was before surgery.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Yushy Zhou
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Address
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Northland District Health Board
Private Bag 9742
Whangarei
0148
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Country
108506
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New Zealand
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Phone
108506
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+64 211367637
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Fax
108506
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Email
108506
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[email protected]
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Contact person for public queries
Name
108507
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Yushy Zhou
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Address
108507
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Northland District Health Board
Private Bag 9742
Whangarei
0148
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Country
108507
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New Zealand
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Phone
108507
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+64 211367637
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Fax
108507
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Email
108507
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[email protected]
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Contact person for scientific queries
Name
108508
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Yushy Zhou
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Address
108508
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Northland District Health Board
Private Bag 9742
Whangarei
0148
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Country
108508
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New Zealand
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Phone
108508
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+64 211367637
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Fax
108508
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Email
108508
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
Patient confidentiality will need to be protected as we are using CT images that are patient record linked.
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
10442
Study protocol
Is available through request from author. Currentl...
[
More Details
]
381362-(Uploaded-01-04-2021-11-39-01)-Study-related document.docx
10444
Informed consent form
381362-(Uploaded-01-04-2021-11-39-31)-Study-related document.docx
10445
Ethical approval
Will be available in due course. Currently awaitin...
[
More Details
]
10446
Clinical study report
Will be available in due course.
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Reverse shoulder arthroplasty with metallic augments to preserve bone and restore joint line in patients with glenoid bone loss.
2022
https://dx.doi.org/10.1053/j.sart.2022.05.001
N.B. These documents automatically identified may not have been verified by the study sponsor.
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