Outcomes of reverse total shoulder arthroplasty following subacromial balloon spacer implantation

Subacromial balloon spacer implantation can be used in the treatment of irreparable rotator cuff tears; but in cases of treatment failure reverse total shoulder arthroplasty (RTSA) may be indicated. The effect of a previously performed subacromial balloon implantation on the outcomes of a subsequent...

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Published inSeminars in arthroplasty Vol. 33; no. 4; pp. 695 - 699
Main Authors Rotman, Dani, Avraham, Omer, Maman, Omer, Piggott, Robert P., Kazum, Efi, Chechik, Ofir, Maman, Eran
Format Journal Article
LanguageEnglish
Published Elsevier Inc 01.12.2023
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Abstract Subacromial balloon spacer implantation can be used in the treatment of irreparable rotator cuff tears; but in cases of treatment failure reverse total shoulder arthroplasty (RTSA) may be indicated. The effect of a previously performed subacromial balloon implantation on the outcomes of a subsequent RTSA is unknown. A single-center retrospective matched cohort study was performed on patients with a history of subacromial balloon spacer implantation who subsequently underwent RTSA in the same shoulder between 2010 and 2021 (Balloon group). A control group of patients who underwent RTSA for irreparable cuff tear/cuff tear arthropathy during the same time period without prior subacromial balloon implantation history was identified and matched by the number of previous rotator cuff repair surgeries and age (No Balloon group). The minimum follow-up was 1 year. Data collected included range of motion, subjective shoulder value, visual analog scale for pain, Quick Disabilities of the Arm, Shoulder, and Hand (QDASH) score, and the proportion of patients achieving patient acceptable symptomatic state (PASS). Thirty cases were included, equally distributed between the two groups. The mean follow-up was 46 ± 23 months without significant differences between groups. The Balloon group included only male patients, whereas the No Balloon group comprised of 47% female patients. The Balloon group had a less advanced arthritic disease as evidenced by a lower Hamada grade compared to the No Balloon group (P = .03). There were no significant differences in preoperative or postoperative range of motion between groups, with an average forward flexion increase of 39° and no gain in rotations. Patient-reported outcomes were comparable between groups: visual analog scale, 4.7 vs. 3.3; subjective shoulder value, 50 vs. 64; and QDASH, 65 vs. 49 (all P > .05). There were four (27%) postoperative complications leading to reintervention in the Balloon group and one (7%) in the No Balloon group (P = .15). In this preliminary study, patients undergoing RTSA for irreparable cuff tear/cuff tear arthropathy had comparable outcomes irrespective of a history of previous subacromial balloon spacer implantation. Further studies in a larger population are indicated to examine the trend toward inferior patient-reported outcomes observed in this small series.
AbstractList Subacromial balloon spacer implantation can be used in the treatment of irreparable rotator cuff tears; but in cases of treatment failure reverse total shoulder arthroplasty (RTSA) may be indicated. The effect of a previously performed subacromial balloon implantation on the outcomes of a subsequent RTSA is unknown. A single-center retrospective matched cohort study was performed on patients with a history of subacromial balloon spacer implantation who subsequently underwent RTSA in the same shoulder between 2010 and 2021 (Balloon group). A control group of patients who underwent RTSA for irreparable cuff tear/cuff tear arthropathy during the same time period without prior subacromial balloon implantation history was identified and matched by the number of previous rotator cuff repair surgeries and age (No Balloon group). The minimum follow-up was 1 year. Data collected included range of motion, subjective shoulder value, visual analog scale for pain, Quick Disabilities of the Arm, Shoulder, and Hand (QDASH) score, and the proportion of patients achieving patient acceptable symptomatic state (PASS). Thirty cases were included, equally distributed between the two groups. The mean follow-up was 46 ± 23 months without significant differences between groups. The Balloon group included only male patients, whereas the No Balloon group comprised of 47% female patients. The Balloon group had a less advanced arthritic disease as evidenced by a lower Hamada grade compared to the No Balloon group (P = .03). There were no significant differences in preoperative or postoperative range of motion between groups, with an average forward flexion increase of 39° and no gain in rotations. Patient-reported outcomes were comparable between groups: visual analog scale, 4.7 vs. 3.3; subjective shoulder value, 50 vs. 64; and QDASH, 65 vs. 49 (all P > .05). There were four (27%) postoperative complications leading to reintervention in the Balloon group and one (7%) in the No Balloon group (P = .15). In this preliminary study, patients undergoing RTSA for irreparable cuff tear/cuff tear arthropathy had comparable outcomes irrespective of a history of previous subacromial balloon spacer implantation. Further studies in a larger population are indicated to examine the trend toward inferior patient-reported outcomes observed in this small series.
Author Chechik, Ofir
Piggott, Robert P.
Avraham, Omer
Maman, Omer
Rotman, Dani
Maman, Eran
Kazum, Efi
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Keywords Retrospective Case Control Study
Cuff tear arthropathy
Level III
Subacromial balloon
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Reverse shoulder arthroplasty
Rotator cuff repair
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Snippet Subacromial balloon spacer implantation can be used in the treatment of irreparable rotator cuff tears; but in cases of treatment failure reverse total...
SourceID crossref
elsevier
SourceType Aggregation Database
Publisher
StartPage 695
SubjectTerms Balloon spacer
Cuff tear arthropathy
Reverse shoulder arthroplasty
Rotator cuff repair
Subacromial balloon
Title Outcomes of reverse total shoulder arthroplasty following subacromial balloon spacer implantation
URI https://dx.doi.org/10.1053/j.sart.2023.06.023
Volume 33
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