4.5 Article

Rotator cuff repair protected with subacromial balloon spacer shows a low rate of non-healing

Journal

KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY
Volume 30, Issue 6, Pages 2123-2129

Publisher

SPRINGER
DOI: 10.1007/s00167-021-06831-1

Keywords

Subacromial spacer; Balloon spacer; Massive rotator cuff tears; Shoulder; Arthroscopic rotator cuff repair

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Arthroscopic repair of chronic posterosuperior rotator cuff tears using a single-row tensionless repair and subacromial spacer as protection resulted in 81.3% tendon integrity at a mean follow-up of 27 months. Clinical outcomes and pain scores significantly improved without severe complications reported after a minimum follow-up of 2 years.
Purpose The purpose of this study was to evaluate clinical outcomes and tendon integrity on magnetic resonance imaging (MRI) of chronic posterosuperior rotator cuff tears treated with single-row tensionless repair and subacromial balloon spacer as protection with a minimum follow-up of 2 years. The hypothesis of this study was that this procedure would have acceptable clinical outcomes and tendon-healing rate without increased complications. Methods This is a retrospective study of patients with chronic posterosuperior rotator cuff tears repaired with a single-row technique protected with a subacromial balloon device. Patients were followed up for a minimum of 2 years. Clinical outcomes were evaluated with American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) and Numerical Rating Scale (NRS) for pain. MRI study was obtained likewise after at least 2 years to assess tendon-healing rate. Statistical comparison was performed between pre-operative and at least 2-year clinical and imaging follow-up. Results Thirty-two patients were included in the study with a mean follow-up of 27 +/- 7 (range 24-48). The mean age of this cohort was 58 +/- 6 (range 41-66) including 15 males and 17 females. The tear size was on average 2.3 cm (range 2-4) and a mean of 2.1 triple-loaded anchors were used (range 2-3). The ASES score significantly increased from a mean of 39 +/- 12 points to a mean of 89 +/- 12 at the final follow-up (P < 0.001). Similarly, pain significantly reduced from a mean pre-operative NRS of 6.8 +/- 1.4 to 0.8 +/- 1.5 at the final follow-up (P < 0.001). MRI scans showed that repair occurred in 26 patients (81.3%). Significant higher ASES score was reached at final follow-up in patients with a healed (Sugaya I-III) tendon when compared to patients with an evidence of tendon discontinuity on MRI study (Sugaya IV-V), 93 +/- 9 and 74 +/- 13, respectively (P < 0.001). Conclusions Arthroscopic repair of chronic posterosuperior rotator cuff tears using a single-row tensionless repair and subacromial spacer as protection resulted in an 81.3% of tendon integrity at a mean follow-up of 27 months. Clinical outcomes and pain scores significantly improved without severe complications reported after a minimum follow-up of 2 years.

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