Learning objectives
To define the concept of irreparable rotator cuff tears.
To describe the subacromial spacer technique as a therapeutic alternative.
To illustrate the typical radiological appearance of the subacromial spacer and its main complications: spacer displacement and tissue responses to implant,
which may include local irritation,
infection,
and inflammation.
Background
Massive,
irreparable rotator cuff tears are a source of pain and disability.
Although,
occasionally,
a shoulder with this pathology may retain acceptable stability,
it is frequently very painful and nonfunctional.
A novel surgical technique uses a biodegradable subacromial spacer,
implanted between the acromion and the humeral head that permits smooth,
frictionless gliding,
restoring shoulder biomechanics.
The deployment of a balloon spacer should reduce subacromial friction during shoulder abduction by lowering the head of the humerus and facilitating humeral gliding against the acromion during movement.
As...
Findings and procedure details
The massive irreparable tears of rotator cuff (IRCT) represents a debilitating condition for the patient as well as it is still a hard challenge to an orthopedic surgeon.
It is important to differentiate between massive and irreparable rotator cuff tears.
By definition,
massive tears have been described as > 5 cm and tears involving two or more tendons.
An IRCT,
as the name suggests,
is any RCT which cannot be repaired back to the rotator cuff footprint on the greater tuberosity of the humerus or...
Conclusion
Biodegradable subacromial balloon spacer is a novel surgical technique in the management of the massive,
irreparable rotator cuff tears.
As with any other implantable material,
the potential risks after implantation may include foreign body response,
and spacer displacement.
Radiology may play an important role in the detection of complications and,
therefore,
in the clinical management of the patient.
References
Gervasi,
E.,
Cautero,
E.
and Dekel,
A.
(2014).
Fluoroscopy-Guided Implantation of Subacromial “Biodegradable Spacer” Using Local Anesthesia in Patients With Irreparable Rotator Cuff Tear.Arthroscopy Techniques,
3(4),
pp.e455-e458.
Savarese,
E.
and Romeo,
R.
(2012).
New Solution for Massive,
Irreparable Rotator Cuff Tears: The Subacromial “Biodegradable Spacer”.Arthroscopy Techniques,
1(1),
pp.e69-e74.
Anley,
C.
(2014).
Arthroscopic treatment options for irreparable rotator cuff tears of the shoulder.World Journal of Orthopedics,
5(5),
p.557.
Senekovic,
V.,
Poberaj,
B.,
Kovacic,
L.,
Mikek,
M.,
Adar,
E.
and Dekel,
A.
(2012).
Prospective clinical study of...