Outcomes of subacromial balloon spacer implantation for irreparable rotator cuff tears: a systematic review and meta-analysis

Berk, Alexander N.; Cregar, William M.; Gachigi, Kennedy K.; Trofa, David P.; Schiffern, Shadley C.; Hamid, Nady; Rao, Allison J.; Saltzman, Bryan M.

doi:10.1016/j.jse.2023.04.016

Cited by 7 publications

(1 citation statement)

References 49 publications

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“…Sin embargo, es importante señalar que este escenario representa una de las limitaciones inherentes a los reportes de casos, pues en cada reporte publicado existió heterogeneidad de los pacientes tratados con el balón subacromial. Esta diversidad de casos afecta la capacidad de obtener una eficacia exhaustiva a largo plazo del implante, especialmente en comparación con otras opciones quirúrgicas (16) .…”

Section: Discussionunclassified

Uso de balón subacromial en lesión masiva irreparable del manguito rotador

Berrocal-Sánchez,

Guillén-Morales,

Torres-Manrique

et al. 2023

An Fac med

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La lesión del manguito rotador es una causa importante de dolor y disfunción del hombro. El tratamiento de las roturas masivas e irreparables del manguito rotador sigue siendo un gran reto para los ortopedistas por su complejidad y severidad. Una de las alternativas prometedoras para su manejo es el uso del balón subacromial. Presentamos el caso de una mujer de 67 años con diagnóstico de rotura masiva e irreparable del manguito rotador en el hombro derecho (grado III de Patte, grado IV Goutallier y grado II de Hamada) sin artrosis glenohumeral, tenosinovitis del bíceps y subescapular íntegro. La escala de constant preoperatorio fue de 40 puntos. Se realizó una reparación parcial artroscópica del tendón supraespinoso e infraespinoso asociado a una tenodesis suprapectoral del bíceps y la colocación del balón subacromial. La paciente realizó rehabilitación con mejoría de los arcos de movilidad, disminución del dolor e incremento de la fuerza del hombro derecho. La escala de constant postoperatorio fue de 80 puntos a la semana doce. El balón subacromial es una buena alternativa de tratamiento para las lesiones irreparables del manguito rotador con resultados óptimos a corto plazo en cuanto a dolor y función.

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Section: Discussionunclassified

Uso de balón subacromial en lesión masiva irreparable del manguito rotador

Berrocal-Sánchez,

Guillén-Morales,

Torres-Manrique

et al. 2023

An Fac med

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Subacromial balloon spacer improves isokinetic performance in patients with massive irreparable rotator cuff tear

Luengo‐Alonso,

Rueda,

Martínez‐Catalán

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeThe aim of this study was to analyse clinical, functional and shoulder kinematics results using subacromial balloon spacer in nonreparable massive rotator cuff tears. Subacromial balloon spacer was hypothesised to improve shoulder kinematics and increases clinical and functional outcomes scores in nonreparable massive rotator cuff tears.MethodsThis is a prospective study in massive rotator cuff tears. From October 2021 to October 2022, a total of 127 shoulders suffering massive rotator cuff tears were initially evaluated. All patients were evaluated preoperatively, at 6 and 12 months. Patients' patient‐reported outcome measures (PROM) subjective values using visual analogue scale (VAS) and the Spanish Western Ontario Rotator Cuff Index (WORC) version were analysed. We also evaluated objective outcomes: constant score, range of movement and kinematic shoulder analysis (isokinetic test to evaluate internal and external rotation forces). Statistical analysis was conducted using SPSS software; continuous variables were presented as means and standard deviations (SDs).ResultsSeventeen nonrepairable massive rotator cuff tears were finally included. Three patients required reverse shoulder arthroplasty before 6 months postoperative. After 1‐year follow‐up, objective and subjective (PROM) outcome scores and isokinetic measurements improved in 13 patients. Preoperative VAS improved from 6.5 ± 2.1 to 2 ± 1.9 points on average at 1‐year follow‐up and WORC index from 1603 ± 217.3 to 699 ± 361.6. Constant score from 42.1 ± 13.1 on average and at 1‐year follow‐up increased to 60.8 ± 14.7. Range of movement also improved in elevation 122.2 ± 39.3 to 166.9 ± 25.8, abduction 120.3 ± 38.6 to 134.6 ± 21.1, external rotation 30.3 ± 19.7 to 86.1 ± 13.8 and internal rotation L4–T12 on average at 1‐year follow‐up. Isokinetic evaluation showed functional improvement 1 year after implantation. Both internal and external rotation improved compared with their healthy shoulder. External rotation improved from 30.3° ± 19.7° preoperatively to 86.1° ± 13.8° (43.7% in the isokinetic study) and internal rotation from L4 preoperatively to L1 (49.8% in isokinetic study) on average.ConclusionAmong the different alternatives for irreparable rotator cuff injuries surgical treatment, subacromial balloon spacer is an effective alternative in selected patients, both in terms of clinical‐functional improvement and short‐term isokinetic results.Level of EvidenceLevel II

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