Arthroscopic Subacromial Balloon Spacer for Massive Rotator Cuff Tears Demonstrates Improved Shoulder Functionality and High Revision-Free Survival Rates at a Minimum 5-Year Follow-Up.

Autor:	Kishan A; Division of Shoulder Surgery, Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, Maryland, U.S.A., Russo R; Division of Nutrition Clinic, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy., Goldfarb SI; Division of Shoulder Surgery, Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, Maryland, U.S.A., Nelson S; Division of Shoulder Surgery, Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, Maryland, U.S.A., Thomas K; Division of Shoulder Surgery, Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, Maryland, U.S.A., Logoteta M; Department of Orthopaedic and Trauma Surgery, Magna Graecia University, Catanzaro, Italy., Giuzio E; Department of Orthopaedic and Trauma Surgery, Villa del Sole Clinic, Catanzaro, Italy., Gasparini G; Department of Orthopaedic and Trauma Surgery, Magna Graecia University, Catanzaro, Italy; Department of Orthopaedic and Trauma Surgery, Villa del Sole Clinic, Catanzaro, Italy., Srikumaran U; Division of Shoulder Surgery, Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, Maryland, U.S.A.. Electronic address: us@jhmi.edu., Familiari F; Department of Orthopaedic and Trauma Surgery, Magna Graecia University, Catanzaro, Italy; Department of Orthopaedic and Trauma Surgery, Villa del Sole Clinic, Catanzaro, Italy; Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, Magna Graecia University, Catanzaro, Italy.
Jazyk:	angličtina
Zdroj:	Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association [Arthroscopy] 2024 Jun 22. Date of Electronic Publication: 2024 Jun 22.
DOI:	10.1016/j.arthro.2024.06.024
Abstrakt:	Purpose: 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 8 years after 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 were calculated for 12-Item Short Form Health Survey scores and Constant-Murley score subscores. Pre- and postsurgery measures statistically compared for anatomic 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 2 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 = .004), critical shoulder angle increased (36.10 to 38.24, P = .001), osteoarthritis grade increased (1.45 to 2.81, P = .001), 12-Item Short Form Health Survey physical score improved (27.40 to 37.69, P = .001), and Constant-Murley total scores increased (26.50 to 68.69, P = .001). Minimal clinically important difference 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. Level of Evidence: Level IV, retrospective study. Competing Interests: Disclosures The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: U.S. reports: is a board member of the American Academy of Orthopaedic Surgeons, American Shoulder and Elbow Surgeons, and Indian Association of Shoulder & Elbow Surgeons; has received funding grants from Arthrex, DePuy Synthes, Thieme Medical Publishers, FX Solutions, and Tigon Medical; is a consultant or advisor for FX Solutions and Tigon Medical; has received speaking and lecture fees for FX Solutions; has equity or stocks with ROMTech, Sonogen, and Tigon Medical; and has a patent with royalties paid to Fx Shoulder and Tigon Medical. F.F. received financial support from MicroPort Orthopedics and is a consultant or advisor for MicroPort Orthopedics. All other authors (A.K., R.R., S.I.G., S.N., K.T., M.L., E.G., G.G.) declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (Copyright © 2024 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu