The Insertion of a Subacromial Balloon Spacer Can Provide Symptom Relief and Functional Improvement at a Minimum 5-year Follow-Up in Patients with Massive Irreparable Rotator Cuff Tears

Purpose The purpose of this study was to examine long-term patient-reported outcomes and range of motion in patients with MIRCTs who underwent subacromial balloon spacer implantation. Methods A retrospective review of all patients who underwent subacromial balloon placement procedure for MIRCTs at our institution was conducted. Patients with adequate preoperative and postoperative data, with at least 5 years of follow up, were included in our study. Outcome measures were range of motion(forward elevation), American Shoulder and Elbow Surgeon(ASES) score, and Visual Analogue Scale(VAS) score. Independent t-test was conducted to check for statistically significant differences between preoperative and postoperative outcome scores, with p-value<0.05 deemed significant. Results Ten patients were identified:four were lost to follow-up beyond 2 years and were excluded. One was converted to an arthroplasty at 1-year mark, and was then lost to follow-up(conversion rate:16.6%). Five patients had at least 5 years of follow-up after the balloon procedure and were involved in our case series analysis. Mean age was 63.1 years, and mean follow-up was 5.8 years (Range: 5-7 years). Preoperatively, mean forward elevation was 110 degrees, mean ASES score was 40.68, and mean VAS score was 6.2. On follow-up, mean forward elevation was 163 degrees(p=0.007), mean ASES score was 90.97(p=0.001), and mean VAS score was 0.9(p=0.004). All patients showed significant improvements in all outcome measures, and none had any significant complications. Conclusion In this study, we found that the use of a subacromial balloon spacer can lead to good outcomes at a minimum 5-year follow-up in patients with MIRCTs. Level of Evidence Level IV, Therapeutic case series