Arthroscopy. 2024 Jun 22:S0749-8063(24)00459-6. doi: 10.1016/j.arthro.2024.06.024. Online ahead of print.
ABSTRACT
PURPOSE: This study aimed to investigate the efficacy of arthroscopic subacromial balloon placement for massive rotator cuff tear (MRCT), assessing patient satisfaction, outcomes, shoulder functionality, pain scores, and revision-free survivorship up to eight years post the initial surgery.
METHODS: In this retrospective study with prospective data collection, patients with MRCTs undergoing balloon placement from 2014 to 2017 were prospectively enrolled. Their outcomes were analyzed retrospectively over a minimum 5-year follow-up. Demographics, patient satisfaction, reoperations, and complications were documented. Minimal clinically important differences (MCIDs) were calculated for SF-12 scores and Constant-Murley score (CMS) sub-scores. Pre- and post-surgery measures statistically compared for anatomical and functional evaluations.
RESULTS: In a study with 61 participants initially, 10 were lost to follow-up over 3 years. Of the remaining 51, 9 were lost at the latest follow-up. The cohort (42 participants, mean age 63.17 ± 7.66 years) was monitored for 83.98 ± 9.50 months. Seven participants required revisions within two years, resulting in an 83.33% revision-free survival rate. Significant improvements were observed from preoperative to latest follow-up: acromiohumeral interval decreased (7.83 to 6.56, p = 0.004), critical shoulder angle increased (36.10 to 38.24, p = 0.001), osteoarthritis grade increased (1.45 to 2.81, p = 0.001), SF-12 physical score improved (27.40 to 37.69, p = 0.001), and Constant-Murley total scores increased (26.50 to 68.69, p = 0.001). MCID for total Constant-Murley scores was 11.78 points. Among those without revisions, satisfaction rates were 11.43% excellent, 57.14% satisfied, and 31.43% dissatisfied.
CONCLUSIONS: Employing a balloon spacer for MRCTs yielded moderate satisfaction at the 5-year follow-up, with stable revision rates within the first 2 years. Notably, low revision surgery rates, high revision-free survival, and significant shoulder functionality improvements were observed at a minimum 5-year follow-up with arthroscopic subacromial balloon placement in conjunction with biceps tenotomy and subacromial bursectomy for MRCT.
PMID:38914297 | DOI:10.1016/j.arthro.2024.06.024
