Sub-acromial balloon spacer for irreparable rotator cuff tears: Is it an appropriate salvage procedure?

Introduction: Irreparable rotator cuff tear (RCT) presents a difficult treatment challenge for the orthopaedic surgeon. Many treatment strategies with varying degrees of success have been performed over the years. One of the suggested surgical treatment options is the use of a biodegradable sub-acro...

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Main Authors: Dan Prat, Shay Tenenbaum, Moshe Pritsch, Ariel Oran, Guy Vogel
Format: Article
Language:English
Published: SAGE Publishing 2018-04-01
Series:Journal of Orthopaedic Surgery
Online Access:https://doi.org/10.1177/2309499018770887
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spelling doaj-dc5d38598d4e430ea0058cf4840dd2982020-11-25T03:24:41ZengSAGE PublishingJournal of Orthopaedic Surgery2309-49902018-04-012610.1177/2309499018770887Sub-acromial balloon spacer for irreparable rotator cuff tears: Is it an appropriate salvage procedure?Dan Prat0Shay Tenenbaum1Moshe Pritsch2Ariel Oran3Guy Vogel4 Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelIntroduction: Irreparable rotator cuff tear (RCT) presents a difficult treatment challenge for the orthopaedic surgeon. Many treatment strategies with varying degrees of success have been performed over the years. One of the suggested surgical treatment options is the use of a biodegradable sub-acromial balloon spacer. Methods: A retrospective study of patients treated with sub-acromial balloon spacer between the years 2011 and 2016 was conducted. Mean follow-up time was 14.4 months. Patient charts were reviewed to evaluate the early clinical results and complications of sub-acromial spacer for irreparable RCTs. Results: The study cohort included 24 shoulders in 22 patients. The average postoperative Disability of the Arm, Shoulder and Hand score was 62.4. The average preoperative University of California at Los-Angeles Shoulder score was 10.9 and improved to 15.9 ( p = 0.001). Forty-six per cent of patients were satisfied with their clinical postoperative outcome. We found moderate–strong positive correlation ( r = 0.64) between preoperative range of motion (ROM) and general satisfaction. None of the postoperative radiographs showed an improvement regarding the proximal migration of the humeral head. In total, four (16.7%) patients experienced postoperative complications, and two (8.3%) patients required an additional surgery as a consequence of a postoperative complication. Conclusion: Our results show unsatisfactory improvement in patients with irreparable RCT treated with the sub-acromial balloon spacer. Careful patient selection with attention to preoperative ROM should be considered. Level of Evidence: Therapeutic level IV.https://doi.org/10.1177/2309499018770887
collection DOAJ
language English
format Article
sources DOAJ
author Dan Prat
Shay Tenenbaum
Moshe Pritsch
Ariel Oran
Guy Vogel
spellingShingle Dan Prat
Shay Tenenbaum
Moshe Pritsch
Ariel Oran
Guy Vogel
Sub-acromial balloon spacer for irreparable rotator cuff tears: Is it an appropriate salvage procedure?
Journal of Orthopaedic Surgery
author_facet Dan Prat
Shay Tenenbaum
Moshe Pritsch
Ariel Oran
Guy Vogel
author_sort Dan Prat
title Sub-acromial balloon spacer for irreparable rotator cuff tears: Is it an appropriate salvage procedure?
title_short Sub-acromial balloon spacer for irreparable rotator cuff tears: Is it an appropriate salvage procedure?
title_full Sub-acromial balloon spacer for irreparable rotator cuff tears: Is it an appropriate salvage procedure?
title_fullStr Sub-acromial balloon spacer for irreparable rotator cuff tears: Is it an appropriate salvage procedure?
title_full_unstemmed Sub-acromial balloon spacer for irreparable rotator cuff tears: Is it an appropriate salvage procedure?
title_sort sub-acromial balloon spacer for irreparable rotator cuff tears: is it an appropriate salvage procedure?
publisher SAGE Publishing
series Journal of Orthopaedic Surgery
issn 2309-4990
publishDate 2018-04-01
description Introduction: Irreparable rotator cuff tear (RCT) presents a difficult treatment challenge for the orthopaedic surgeon. Many treatment strategies with varying degrees of success have been performed over the years. One of the suggested surgical treatment options is the use of a biodegradable sub-acromial balloon spacer. Methods: A retrospective study of patients treated with sub-acromial balloon spacer between the years 2011 and 2016 was conducted. Mean follow-up time was 14.4 months. Patient charts were reviewed to evaluate the early clinical results and complications of sub-acromial spacer for irreparable RCTs. Results: The study cohort included 24 shoulders in 22 patients. The average postoperative Disability of the Arm, Shoulder and Hand score was 62.4. The average preoperative University of California at Los-Angeles Shoulder score was 10.9 and improved to 15.9 ( p = 0.001). Forty-six per cent of patients were satisfied with their clinical postoperative outcome. We found moderate–strong positive correlation ( r = 0.64) between preoperative range of motion (ROM) and general satisfaction. None of the postoperative radiographs showed an improvement regarding the proximal migration of the humeral head. In total, four (16.7%) patients experienced postoperative complications, and two (8.3%) patients required an additional surgery as a consequence of a postoperative complication. Conclusion: Our results show unsatisfactory improvement in patients with irreparable RCT treated with the sub-acromial balloon spacer. Careful patient selection with attention to preoperative ROM should be considered. Level of Evidence: Therapeutic level IV.
url https://doi.org/10.1177/2309499018770887
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