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Clinical outcomes at medium-term follow-up of sub-acromial balloon spacer insertion in the operative management of massive rotator cuff tears

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Abstract

Introduction

The management of massive rotator cuff tears (RCTs) remains a debated topic amongst orthopaedic surgeons, with a wide spectrum of treatment options available. In recent years, the use of sub-acromial balloon spacers has emerged as an option in the management of massive RCTs. The purpose of this study is to evaluate the clinical outcomes of patients with massive RCTs who underwent arthroscopic sub-acromial balloon spacer insertion at medium-term follow-up.

Methods

All consecutive patients in our institution who had undergone sub-acromial balloon spacer insertion under the senior author from 2015 to 2020 were identified and followed up via telephone survey. Patient demographics, patient-reported outcomes, complications and subsequent surgeries were all analysed using the SPSS.

Results

Overall, 45 patients (31 males) including 36 retired (80.0%) patients, with a mean age of 70.3 ± 7.0 (40–83) years, and mean follow-up of 37.1 ± 16.4 (12–62) months were included. At final follow-up, the mean ASES score was 73.4 ± 21.8 (25–100), the mean SSV was 76.4 ± 16.0 (45–100), baseline VAS score was 0.3 ± 1.1 (0.0–6.0) and functional VAS score was 2.6 ± 2.3 (0.0–8.0), with a total of 89.9% of patients (n = 40) being satisfied at final follow-up. This series reported no intra-operative complications (0.0%), with 4 patients (8.9%) required subsequent procedures to the ispilateral shoulder post-sub-acromial balloon insertion.

Conclusion

In selected patient cohorts, the use of sub-acromial balloon spacer insertion represents a minimally invasive, viable surgical option in the management of massive rotator cuff tears, with satisfactory patient-reported outcomes, high rates of satisfaction and a low complication rate reported at medium-term follow-up.

Level of evidence: III; Retrospective Cohort Study

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References

  1. Thorsness R, Romeo A (2016) Massive rotator cuff tears: trends in surgical management. Orthopedics 39(3):145–151

    Article  Google Scholar 

  2. Gerber C, Wirth SH, Farshad M (2011) Treatment options for massive rotator cuff tears. J Shoulder Elbow Surg 20(2 Suppl):S20–S29

    Article  Google Scholar 

  3. Matthews TJ et al (20016) Pathology of the torn rotator cuff tendon. Reduction in potential for repair as tear size increases. J Bone Joint Surg Br 88(4):489–95

  4. Cofield RH (1985) Rotator cuff disease of the shoulder. J Bone Joint Surg Am 67(6):974–979

    Article  CAS  Google Scholar 

  5. Gerber C, Fuchs B, Hodler J (2000) The results of repair of massive tears of the rotator cuff. J Bone Joint Surg Am 82(4):505–515

    Article  CAS  Google Scholar 

  6. Savarese E, Romeo R (2012) New solution for massive, irreparable rotator cuff tears: the subacromial “biodegradable spacer.” Arthrosc Tech 1(1):e69-74

    Article  Google Scholar 

  7. Stewart RK et al (2019) Outcomes of subacromial balloon spacer implantation for massive and irreparable rotator cuff tears: a systematic review. Orthop J Sports Med 7(10):2325967119875717

    Article  Google Scholar 

  8. Milgrom C et al (1995) Rotator-cuff changes in asymptomatic adults. The effect of age, hand dominance and gender. J Bone Joint Surg Br 77(2):296–8

  9. Codding JL, Keener JD (2018) Natural history of degenerative rotator cuff tears. Curr Rev Musculoskelet Med 11(1):77–85

    Article  Google Scholar 

  10. Teunis T et al (2014) A systematic review and pooled analysis of the prevalence of rotator cuff disease with increasing age. J Shoulder Elbow Surg 23(12):1913–1921

    Article  Google Scholar 

  11. Gagnier JJ et al (2017) Do medical comorbidities affect outcomes in patients with rotator cuff tears? Orthop J Sports Med 5(8):2325967117723834–2325967117723834

    Article  Google Scholar 

  12. Ricci M et al (2017) A clinical and radiological study of biodegradable subacromial spacer in the treatment of massive irreparable rotator cuff tears. Acta bio-medica : Atenei Parmensis 88(4S):75–80

    Google Scholar 

  13. Piekaar RSM et al (2018) Early promising outcome following arthroscopic implantation of the subacromial balloon spacer for treating massive rotator cuff tear. Musculoskelet Surg 102(3):247–255

    Article  CAS  Google Scholar 

  14. Singh S (2017) A biomechanical study examining the subacromial balloon spacer and superior capsular reconstruction in the treatment of massive, irreparable rotator cuff tears. 2017, The University of Western Ontario: Electr Thesis Dissert Repos

  15. Gervasi E et al (2016) Fluoroscopy-guided biodegradable spacer implantation using local anesthesia: safety and efficacy study in patients with massive rotator cuff tears. Musculoskelet Surg 100(Suppl 1):19–24

    Article  CAS  Google Scholar 

  16. Basat HC, Kircil C, Armangil M, Demirts M (2017) Treatment alternative for irreparable rotator cuff ruptures: arthroscopic biodegradable balloon. Niger J Clin Pract 20(8):952–957

  17. Prat D et al (2018) Sub-acromial balloon spacer for irreparable rotator cuff tears: Is it an appropriate salvage procedure? J Orthop Surg (Hong Kong) 26(2):2309499018770887

    Article  Google Scholar 

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Correspondence to Martin S. Davey.

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Granted from local I.R.B. with reference number C.A. 2488.

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Davey, M.S., Kaar, K. Clinical outcomes at medium-term follow-up of sub-acromial balloon spacer insertion in the operative management of massive rotator cuff tears. Ir J Med Sci 191, 1687–1691 (2022). https://doi.org/10.1007/s11845-021-02760-7

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  • DOI: https://doi.org/10.1007/s11845-021-02760-7

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