Key result
Balloon spacer insertion for irreparable massive rotator cuff tears improved mean Oxford Shoulder Scores from 23.6 to 29.6 (p<0.02), though only 32% achieved a successful clinical outcome.
Why the study?
Does arthroscopic insertion of a balloon spacer improve Oxford Shoulder Scores in patients with irreparable massive rotator cuff tears?
Observational (n=22)
Does arthroscopic insertion of a balloon spacer improve Oxford Shoulder Scores in patients with irreparable massive rotator cuff tears?
Absolute Event Rate: 29.6% vs 23.6%
p-value: p=< 0.02
The balloon spacer provides successful clinical outcomes in only a minority of patients with irreparable massive rotator cuff tears, with older patients and those with lower baseline scores at higher risk of failure.
Does not support routine balloon spacer adoption; leaves open optimal patient selection for future trials.
We report our medium-term outcomes of the balloon spacer in treating irreparable massive rotator cuff tears (MRCT). Twenty-two patients (17 male:5 female; mean age 68.2 years) had a balloon spacer arthroscopically inserted between September 2013–May 2017 after failing non-surgical management or rotator cuff repair. Oxford Shoulder Scores (OSS) were collected prospectively at baseline and prior to reverse total shoulder replacement (rTSR) or at most recent follow up for those with the balloon spacer still in-situ. A significant OSS improvement at mean follow-up 31.4 months (5–63) was found analysing all patients who had a balloon inserted (23.6 vs 29.6; p < 0.02). However, 6 patients (27%) converted to rTSR at a mean time of 11 months post balloon insertion with a mean OSS deterioration of 1.1. Six patients with the balloon still in-situ demonstrated either a deterioration or an OSS improvement less than the minimal clinically important difference (MCID). Three patients had an OSS improvement greater than the MCID but remained symptomatic. Seven patients (32%) had a successful clinical outcome. Patients converting to rTSR or with poor clinical outcomes were significantly older with significantly lower baseline OSS compared to those with the best outcomes. The balloon spacer is effective in a minority of patients in the medium term. The majority either convert to rTSR or remain symptomatic with the risk of failure higher in those who are older with a low baseline OSS.
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Oderuth et al. (2021) conducted an observational in Irreparable massive rotator cuff tears (MRCT) (n=22). Balloon spacer vs. Baseline (pre-intervention) was evaluated on Oxford Shoulder Scores (OSS) (p=< 0.02). Balloon spacer insertion for irreparable massive rotator cuff tears improved mean Oxford Shoulder Scores from 23.6 to 29.6 (p<0.02), though only 32% achieved a successful clinical outcome.
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