The experience with the use of a subacromial balloon in the treatment of patients with large, massive, irreparable rotator cuff tears
Мaksim F. Lazko , Alexey P. Prizov , Fedor L. Lazko , Evgeny A. Beliak , Ivan G. Maglaperidze , Aleksandr V. Kyznetsov , Alexander A. Akhpashev
Journal of Clinical Practice ›› 2020, Vol. 11 ›› Issue (4) : 14 -22.
The experience with the use of a subacromial balloon in the treatment of patients with large, massive, irreparable rotator cuff tears
Background. Large, massive irreparable rotator cuff tears lead to a significant decrease in the function of the shoulder joint together with the development of a pronounced pain syndrome. Such injuries are difficult to treat, and the number of relapses, when trying to restore them, is quite high. The installation of a subacromial balloon is the method of choice for this group of patients and allows restoring the function of the shoulder joint fairly successfully. Aim: to evaluate the results of the treatment of patients with massive irreparable rotator cuff tears injuries in a prospective study from 2016 to 2018. Methods. The results of the arthroscopic treatment of large, irreparable rotator cuff injuries in 25 patients (with the average age of 67 ± 5 years) with the installation of a subacromial balloon are presented. In all the clinical cases, there was a pronounced (grades 3–4, according to the Goutallier classification) fatty dystrophy of the rotator cuff muscles (supraspinatus or in combination with subaspinatus). All the patients underwent the subacromial space release with a thorough bursectomy and subsequent installation of a subacromial balloon. Results. The average score on the UCLA scale was 14 ± 3 points (11–17) before the operation and 31±2 points (29–33) 12 months after the operation, the results were considered good and excellent. Conclusion. The results obtained allow us to evaluate the described technique as low-traumatic, simple and fast in its accomplishment, aimed at the reduction of the pain syndrome and restoration of the upper extremity function.
arthroscopy / rotator cuff of the shoulder joint / irreparable injuries of the rotator cuff of the shoulder / shoulder joint / subacromial balloon
| [1] |
Bartolozzi A, Andreychik D, Ahmad S. Determinants of outcome in the treatment of rotator cuff disease. Clin Orthop Relat Res. 1994;308:90–97. |
| [2] |
Galatz LM, Ball CM, Teefey SA, et al. The outcome and repair integrity of completely arthroscopically repaired large and massive rotator cuff tears. J Bone Joint Surg Am. 2004;86(2):219–224. doi: 10.2106/00004623-200402000-00002. |
| [3] |
Burkhart SS, Barth JR, Richards DP, et al. Arthroscopic repair of massive rotator cuff tears with stage 3 and 4 fatty degeneration. Arthroscopy. 2007;23(4):347-354. doi: 10.1016/j.arthro.2006.12.012. |
| [4] |
Keener JD, Wei AS, Kim HM, et al. Revision arthroscopic rotator cuff repair: Repair integrity and clinical outcome. J Bone Joint Surg Am. 2010;92(3):590–598. doi: 10.2106/JBJS.I.00267. |
| [5] |
Abouelela AK, Abou Elsoud M. Latissimus dorsi transfer for irreparable rotator cuff tears. Egypt Orthop J. 2014;49(4):330. doi: 10.4103/1110-1148.154097. |
| [6] |
Burkhart SS, Pranckun JJ, Hartzler RU. Superior capsular reconstruction for the operatively irreparable rotator cuff tear: clinical outcomes are maintained 2 years after surgery. Arthroscopy. 2019; 36(2):373–380. doi: 10.1016/j.arthro.2019.08.035. |
| [7] |
Juhan T, Stone M, Jalali O, et al. Irreparable rotator cuff tears: Current treatment options. Orthop Rev (Pavia). 2019;11(3):8146. doi: 10.4081/or.2019.8146. |
| [8] |
Savarese E and Rocco Romeo. New Solution for Massive, Irreparable Rotator Cuff Tears: The Subacromial “Biodegradable Spacer”. Arthroscopy Techniques. 2012; 1(1) : e69-e74. |
| [9] |
Senekovic V, Poberaj B, Kovacic L, et al. The biodegradable spacer as a novel treatment modality for massive rotator cuff tears: a prospective study with 5-year follow-up. Arch Orthop Trauma Surg. 2017;137(1):95–103. doi: 10.1007/s00402-016-2603-9. |
| [10] |
Deranlot J, Herisson O, Nourissat G, et al. Arthroscopic subacromial spacer implantation in patients with massive irreparable rotator cuff tears: clinical and radiographic results of 39 retrospectives cases. Arthroscopy. 2017;33(9):1639–1644. doi: 10.1016/j.arthro.2017.03.029. |
| [11] |
Goutallier D, Postel JM, Bernageau J, et al. Fatty muscle degeneration in cuff ruptures. Pre- and postoperative evaluation by CT scan. Clin Orthop Relat Res. 1994;304:78–83. |
| [12] |
Patte D. Classification of rotator cuff lesions. Clin Orthop Relat Res. 1990;254:81–86. |
| [13] |
Outerbridge RE. The etiology of chondromalacia patellae. 1961. Clin Orthop Relat Res. 2001;(389):5–8. doi: 10.1097/00003086-200108000-00002. |
Lazko М.F., Prizov A.P., Lazko F.L., Beliak E.A., Maglaperidze I.G., Kyznetsov A.V., Akhpashev A.A.
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