Treatment of Massive Irreparable Rotator Cuff Tear using Subacromial Balloon Spacer

Objectives:
Massive Irreparable rotator cuff tears (MIRCT) is a relatively common condition. However, until 2020 there is no formal acceptable guideline for the treatment of this condition. Treatment options include Conservative treatment (physical therapy, activity modification, injections,) and surgical treatment (arthroscopic debridement, partial tendon repair, tendon transfer, superior capsular reconstruction and revers total shoulder arthroplasty). All have shown acceptable results. The subacromial spacer (SAS) is another treatment option, presented in 2010. This arthroscopically implanted device is inserted between the acromion and the humeral head and serves as a spacer that reduces pain and allows reeducation of the deltoid muscle. Several studies showed promising results. Our hypothesis was that the treatment of MIRCT using the subacromial balloon spacer shows good pain reduction and good functional improvement compares with current literature.

Methods:
Using the Ziv Medical Center medical record archive, we collected the patients who were treated for MIRCT using SAS. Physical examination and functional questionnaires where collected, and XRAY of the shoulder where performed. The results were compared with data from the most recent literature concerning MIRCT.

Results:
16 patients were recruited. 11 males and 5 females. The average age was 64.0±9.2. Mean follow-up time was 42 months. Average shoulder ROM was in correlation with normal function for Activities for Daily Living (ADL). 37.5% of the patients had negative job test. The average DASH score results were 39.6±30.2. The average of the CONSTANT score results was 55.8±23.2. Average Visual Analog Score (VAS) was 4.8±2.8. All results were compared to recent literature showing no statistical difference. 56% of the patient where willing to go through the same surgery again.

Conclusion:
Our study shows that the treatment of MIRCT using SAS present good functional results similar to more complicated treatment methods and therefore should be considered as a standard treatment option.