Isolated Subacromial Balloon Spacer Implantation for Massive Irreparable Rotator Cuff Tears Is Associated With Improvement in Pain and Function at a Minimum 1-Year Follow-Up

PURPOSE: To evaluate the efficacy of isolated subacromial balloon spacer implantation in patients with massive irreparable rotator cuff tears (MIRCTs), as evidenced by changes in patient-reported outcomes and range-of-motion values. METHODS: A retrospective review of prospectively collected data was conducted for patients with MIRCTs who underwent subacromial balloon spacer implantation alone without any concomitant procedures, with a minimum 1-year follow-up. Patient demographics and preoperative magnetic resonance imaging findings were recorded. Outcomes included the American Shoulder and Elbow Surgeons (ASES) score, visual analog scale (VAS) pain score, active forward elevation, complications, and reoperations. RESULTS: A total of 34 patients (18 women, 16 men) were included. The mean age was 65.9 years, and the mean follow-up period was 15.9 months. On preoperative magnetic resonance imaging, the mean posterosuperior rotator cuff tear size was 3.57 cm, mean retraction size was 3.7 cm, 71% were Goutailler grade III/IV, and 94% had none or minimal osteoarthritis. There were no complications, and 2 patients (5.9%) underwent conversion to reverse shoulder arthroplasty. Significant improvements were observed in mean forward elevation (136.6 ° to 150.4 °, P = .009), ASES scores (39.5 to 76.1, P < .001), and VAS scores (6.1 to 2.1, P < .001) at final follow-up. At the final follow-up, 90.3% of patients reached the minimal clinically important difference for ASES scores, and 87.1% reached the minimal clinically important difference for VAS scores. CONCLUSIONS: Isolated subacromial balloon spacer implantation is an effective treatment option for patients with MIRCTs, evident by the significant improvements in forward elevation and high rates of clinically meaningful ASES and VAS scores at a minimum 1-year follow-up. LEVEL OF EVIDENCE: Level IV, retrospective case series.