Isolated Subacromial Balloon Spacer Implantation for Massive Irreparable Rotator Cuff Tears Is Associated with Improvement In Pain and Function at Minimum One Year Follow-Up.

Abstract

Purpose: The purpose of this study was to evaluate the efficacy of isolated subacromial balloon spacer implantation in patients with MIRCTs, as evidenced by changes in patient reported outcomes and range of motion values.

Methods: A retrospective review of prospectively collected data was conducted for MIRCT patients who underwent subacromial balloon spacer implantation alone without any concomitant procedures, with a minimum follow-up of one year. Patient demographics and preoperative MRI findings were recorded. Outcomes included the American Shoulder and Elbow Surgeon (ASES) score, Visual Analogue Scale (VAS) pain score, active forward elevation, as well as complications and reoperations.

Results: A total of 34 patients (18 female, 16 male) were included. The mean age was 65.9 years and the mean follow-up period was 15.9 months. On preoperative MRI, the mean posterosuperior rotator cuff tear size was 3.57 cm, mean retraction size was 3.7 cm, 71% were Goutailler grade III/IV, and 94% had none or minimal osteoarthritis. There were no complications, and two patients (5.9%) underwent conversion to reverse shoulder arthroplasty. Significant improvements were observed in mean forward elevation (136.6° to 150.4°, p=0.009), ASES scores (39.5 to 76.1, p<0.001) and VAS score (6.1 to 2.1, p<0.001) at final follow up. At final follow-up, 90.3% of patients reached minimal clinically important difference(MCID) for ASES scores and and 87.1% reached MCID for VAS scores.

Conclusion: Isolated subacromial balloon spacer implantation is an effective treatment option for patients with MIRCTs evident by the significant improvements in forward elevation, and high rates of clinically meaningful ASES and VAS scores at minimum one year follow-up.