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Subacromial Balloon Spacer for Massive, Irreparable Rotator Cuff Tears is Associated with Improved Shoulder Function and High Patient Satisfaction

Subacromial Balloon Spacer for Massive, Irreparable Rotator Cuff Tears is Associated with Improved Shoulder Function and High Patient Satisfaction

Filippo Familiari, MD, Prof., ITALY Suresh K Nayar, MD, UNITED STATES Raffaella Russo, MD, ITALY Marco De Gori, ITALY Francesco Ranuccio, MD, ITALY Valerio Mastroianni, MD, ITALY Ermenegildo Giuzio, Prof, ITALY Olimpio Galasso, MD, Prof., ITALY Giorgio Gasparini, MD, Prof., ITALY Edward G. McFarland, UNITED STATES Uma Srikumaran, MD, MBA, MPH, UNITED STATES

Villa del Sole Clinic, Catanzaro, ITALY


2021 Congress   ePoster Presentation     Not yet rated

 

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Sports Medicine

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Summary: At three year follow-up, subacromial balloon spacer placement for massive irreparable rotator cuff tears showed significant improvements in shoulder function scoring with limited need for revision surgery and high patient satisfaction rates.


Purpose

To investigate associations between clinical/demographic parameters and Constant-Murley (CM) scores after subacromial balloon placement for massive, irreparable rotator cuff tears (MIRCTs) and to evaluate implant survival, shoulder function, and patient satisfaction.

Methods

We prospectively analyzed patients with rotator cuff tears deemed irreparable on preoperative MRI for whom nonoperative therapy was unsuccessful and who underwent balloon placement from 2014–2017 with minimum 1-year follow-up. Shoulder function was assessed using CM scores and the 12-Item Short Form Health Survey (SF-12).

Results

Fifty-one patients (22 women) with a mean age at surgery of 63 years (range, 50–78) were included. Mean follow-up was 36 months (range, 24–56). Postoperative acromiohumeral interval and total preoperative CM score predicted postoperative CM score at final follow-up. Implant survival rates were 92% at 6 and 12 months, 90% at 2 years, and 87% at 3 and 4 years. Five patients underwent reverse total shoulder arthroplasty, and 1 underwent latissimus dorsi tendon transfer. Postoperatively, mean (± standard deviation) CM scores improved for range of motion (from 11 ± 5.4 to 34 ± 6.8) and strength (from 13 ± 5.4 to 28 ± 12) (both, p<0.01). Total CM score improved from 27 ± 7.4 preoperatively to 77 ± 15 postoperatively (p<0.01). SF-12 physical and mental component summary scores improved from 27 ± 5.0 to 51 ± 6.5 (p=0.02) and 44 ± 15 to 56 ± 8.0, respectively (p<0.01). Thirty-eight patients reported excellent satisfaction; 8 were satisfied, and 5 were dissatisfied. Fifty patients (98%) exceeded the minimal clinically important difference (=10.4) and patient acceptable symptom state (=44).

Conclusions

At mean 3-year follow-up, subacromial balloon spacer placement for MIRCTs was associated with significant improvement in shoulder function, limited need for revision surgery, and high patient satisfaction. Greater postoperative acromiohumeral interval and lower preoperative CM scores predicted lower postoperative CM scores at final follow-up.


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