Subacromial Balloon Spacer for Massive Irreparable Rotator Cuff Tear is Cost-Effective in Older, Low-Demand Patients With Massive Irreparable Rotator Cuff Tear and Severe Comorbidities.
{"title":"Subacromial Balloon Spacer for Massive Irreparable Rotator Cuff Tear is Cost-Effective in Older, Low-Demand Patients With Massive Irreparable Rotator Cuff Tear and Severe Comorbidities.","authors":"Adnan Saithna","doi":"10.1016/j.arthro.2024.10.003","DOIUrl":null,"url":null,"abstract":"<p><p>The InSpace subacromial balloon spacer (Stryker, USA) is indicated for the treatment of massive irreparable rotator cuff tears. The device is placed in the subacromial space with the aim of restoring shoulder function by limiting painful acromiohumeral contact and recentering the superiorly migrated humeral head. However, controversy exists because two randomized controlled trials have produced conflicting findings with regards to efficacy. These findings, along with narrow indications have led to low utilization of the balloon amongst European and Latin American Surgeons. The controversy generated by conflicting RCTs poses challenges in the interpretation of cost effectiveness especially when the role of the balloon amongst a plethora of other options including superior capsule reconstruction (either with long head of biceps or dermal allograft), graft augmentation, tendon transfer, biologic tuberoplasty, acromial resurfacing, and reverse shoulder arthroplasty is not well defined. However, it is my opinion that the balloon has particular value in older, low-demand patients, in whom severe co-morbidities make a shorter surgical duration and quicker recovery appealing.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":null,"pages":null},"PeriodicalIF":4.4000,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.arthro.2024.10.003","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
Abstract
The InSpace subacromial balloon spacer (Stryker, USA) is indicated for the treatment of massive irreparable rotator cuff tears. The device is placed in the subacromial space with the aim of restoring shoulder function by limiting painful acromiohumeral contact and recentering the superiorly migrated humeral head. However, controversy exists because two randomized controlled trials have produced conflicting findings with regards to efficacy. These findings, along with narrow indications have led to low utilization of the balloon amongst European and Latin American Surgeons. The controversy generated by conflicting RCTs poses challenges in the interpretation of cost effectiveness especially when the role of the balloon amongst a plethora of other options including superior capsule reconstruction (either with long head of biceps or dermal allograft), graft augmentation, tendon transfer, biologic tuberoplasty, acromial resurfacing, and reverse shoulder arthroplasty is not well defined. However, it is my opinion that the balloon has particular value in older, low-demand patients, in whom severe co-morbidities make a shorter surgical duration and quicker recovery appealing.
期刊介绍:
Nowhere is minimally invasive surgery explained better than in Arthroscopy, the leading peer-reviewed journal in the field. Every issue enables you to put into perspective the usefulness of the various emerging arthroscopic techniques. The advantages and disadvantages of these methods -- along with their applications in various situations -- are discussed in relation to their efficiency, efficacy and cost benefit. As a special incentive, paid subscribers also receive access to the journal expanded website.