The subacromial balloon spacer for massive irreparable rotator cuff tears: approximately 3 years of prospective follow-up

Piekaar, Roderick S M; Bouman, I. C. E.; Kampen, Paulien M. van; Eijk, Floor van; Huijsmans, Pol E.

doi:10.1007/s12306-019-00614-1

Cited by 36 publications

(34 citation statements)

References 25 publications

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“…Risk of bias assessment using the MINORS criteria is displayed in Table 2 [38][39][40][41][42][43][44][45][46][47] and Figure 2, and design characteristics of selected studies are included in Tables 3 and 4. [38][39][40][41][42][43][44][45][46][47] Two studies by Piekaar et al 1,42 were retrieved, which included clinical results from the same group at 1 and 3 years of follow-up after implantation of a subacromial balloon spacer. Only the results from Piekaar et al 42 reporting 3-year follow-up were included in the results and statistical analysis of the present study.…”

Section: Search Resultsmentioning

confidence: 99%

“…[38][39][40][41][42][43][44][45][46][47] Two studies by Piekaar et al 1,42 were retrieved, which included clinical results from the same group at 1 and 3 years of follow-up after implantation of a subacromial balloon spacer. Only the results from Piekaar et al 42 reporting 3-year follow-up were included in the results and statistical analysis of the present study.…”

Section: Search Resultsmentioning

confidence: 99%

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Implantable Subacromial Balloon Spacers in Patients With Massive Irreparable Rotator Cuff Tears: A Systematic Review of Clinical, Biomechanical, and Financial Implications

Johns

Ailaney

Lacy

et al. 2020

Arthroscopy, Sports Medicine, and Rehabilitation

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To determine the clinical, biomechanical, and financial impact of the use of subacromial balloon spacers in the surgical management of massive, irreparable rotator cuff tears (RCTs). Methods: All studies assessing the use of implantable subacromial balloon spacers for management of massive, irreparable RCTs were systematically searched. Risk of bias was assessed using Methodological Index for Non-Randomized Studies criteria. Data extraction and analysis was performed for pain and function scores, shoulder range of motion (ROM), glenohumeral contact pressure and vertical migration of humeral head, and cost. Subjective synthesis was performed with forest plots when outcomes were reported in 3 or more studies. Results: In total, 19 studies met inclusion criteria for analysis; 337 patients (mean age 68 years) had 343 subacromial balloon spacer implantations. Throughout a mean follow-up of 33 months, there was significant

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Section: Search Resultsmentioning

confidence: 99%

Section: Search Resultsmentioning

confidence: 99%

Implantable Subacromial Balloon Spacers in Patients With Massive Irreparable Rotator Cuff Tears: A Systematic Review of Clinical, Biomechanical, and Financial Implications

Johns

Ailaney

Lacy

et al. 2020

Arthroscopy, Sports Medicine, and Rehabilitation

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“…It has therefore been suggested that proximal migration of the humerus could be prevented by sliding a subacromial spacer implant. This is the case for example with subacromial balloons [15] [16]. However, when the arm is raised, the greater tuberosity will engage under the acromion and the subacromial space will become almost obsolete.…”

Section: Discussionmentioning

confidence: 99%

Use of Gracile and Semi-tendinosus tendons (GRAST) for the reconstruction of irreparable rotator cuff tears

Protais

Laurent-Perrot

Artuso

et al. 2020

Preprint

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Purpose Irreparable rotator cuff tears are common and difficult to treat. Techniques for "filling the loss of substance" require fixation to the rotator cuff stump (tendon augmentation) or to the glenoid (superior capsular reconstruction), which are complicated by the narrow working zone of the subacromial space. The main objective of this study was to determine whether a braided graft of gracilis (GR) and semitendinosus (ST) could fill a loss of tendon substance from an irreparable rupture of the supra- and infraspinatus, by fixing the graft to the greater tuberosity and the spine of the scapula. Methods This was a cadaveric study with the use of ten specimens. The GRA and ST tendons were harvested, braided and reinforced with suture. An experimental tear of the supraspinatus (SE) and upper infraspinatus (IE) retracted at the glenoid was made. The GRAST transplant was positioned over the tear. The transplant was attached to the greater tuberosity by two anchors and then attached to the medial third of the scapular spine by trans-osseous stitching. The percentage of filling obtained was then measured and passive mobility of the shoulder was assessed. Results The Braided-GRAST allowed a 100% filling of the loss of tendon substance. Mobility was complete in all cases. Conclusion This technique simplifies the medial fixation and restores the musculo-tendinous chain where current grafting techniques only fill a tendinous defect. The transplant could have a subacromial "spacer" effect and lower the humeral head. The donor site morbidity and the fate of the transplant in-vivo are two limits to be discussed. This anatomical study paves the way for clinical experimentation.

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“…In massive irreparable rotator cuff tears, several treatment options include arthroscopic debridement, partial repair, [1][2][3] superior capsular reconstruction (SCR), [4][5][6] auto-or allograft interposition, 7) balloon spacer arthroplasty, [8][9][10] trapezius transfer, and latissimus dorsi (LD) transfer 11) or reverse total shoulder arthroplasty (RTSA). [12][13][14][15] Arthroscopic debridement provides pain relief by removing the damaged torn rotator cuff tissue.…”

Section: Introductionmentioning

confidence: 99%

“…Balloon spacer arthroplasty has recently been proposed, and acts by preventing humeral head migration by placing a biodegradable saline-filled spacer between the humeral head and acromion; however, there is no long-term follow-up study to determine the outcome. [8][9][10] Also, RTSA is very effective for irreparable rotator cuff tears in elderly patients, [12][13][14][15] but due to the questionable longevity of RTSA and limited treatment options after failure, this procedure is not an ideal option for young, active patients. In the future, long term follow-up studies that compare different treatment modalities are required, to verify the superiority of a specific procedure and to determine patient specific indications.…”

Section: Introductionmentioning

confidence: 99%

Mid-term Clinical and Radiological Outcomes of Latissimus Dorsi Tendon Transfer in Massive Rotator Cuff Tears

Suh

Tankshali

et al. 2019

Clin Shoulder Elbow

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Background: This retrospective study was undertaken to evaluate mid-term clinical and radiological outcomes of lattisimus dorsi (LD) tendon transfer in patients with irreparable massive rotator cuff tears (MRCT). We hypothesize that LD tendon transfer would provide safe and satisfactory clinical outcomes at mid-term follow-up.Methods: From November 2008 to December 2016, 23 patients (57.5 ± 4.4 years; 20 male, 3 female) who underwent LD tendon transfer for massive tears, were enrolled. Inclusion criteria were irreparable MRCT. Exclusion criteria included full thickness subscapularis tear, rotator cuff arthropathy, anterosuperior rotator cuff tear, and osteoarthritis. Mean follow-up period was 4.7 ± 4.0 years (range, 2?12 years). Clinical assessment (American Shoulder and Elbow Surgeons [ASES], University of California, Los Angeles [UCLA], Simple Shoulder Test [SST]) and radiographic assessment (osteoarthritis [OA], acromiohumeral distance [AHI]) were evaluated.Results: ASES, UCLA and SST scores, and range of motion (ROM), except internal rotation, improved significantly at the last follow-up (<i>p</i><0.05). Also, AHI was significantly improved at the last follow-up, from 6.6 mm to 8.2 mm (<i>p</i>=0.008). At the final follow-up, the radiologic stages of the glenohumeral osteoarthritis were determined as stage 1 in 9 patients, stage 2 in 10 patients, stage 3 in 2 patients, and stage 4 in 2 patients. Complications were observed in 21.7% cases: 3 re-tears and 2 infections were noted in our study.Conclusions: LD tendon transfer for irreparable MRCT provides satisfactory clinical outcomes at mid-term follow-up. Mild degenerative osteoarthritis (stage 1, 2) of the shoulder joint are common at the mid-term follow-up. Also, complications such as tear, infection should be considered.

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The subacromial balloon spacer for massive irreparable rotator cuff tears: approximately 3 years of prospective follow-up

Cited by 36 publications

References 25 publications

Implantable Subacromial Balloon Spacers in Patients With Massive Irreparable Rotator Cuff Tears: A Systematic Review of Clinical, Biomechanical, and Financial Implications

Implantable Subacromial Balloon Spacers in Patients With Massive Irreparable Rotator Cuff Tears: A Systematic Review of Clinical, Biomechanical, and Financial Implications

Use of Gracile and Semi-tendinosus tendons (GRAST) for the reconstruction of irreparable rotator cuff tears

Mid-term Clinical and Radiological Outcomes of Latissimus Dorsi Tendon Transfer in Massive Rotator Cuff Tears

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