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. 2012 May 4;1(1):e69-74.
doi: 10.1016/j.eats.2012.02.002. Print 2012 Sep.

New solution for massive, irreparable rotator cuff tears: the subacromial "biodegradable spacer"

Eugenio Savarese  1 , Rocco Romeo
Affiliations

New solution for massive, irreparable rotator cuff tears: the subacromial "biodegradable spacer"

Eugenio Savarese et al. Arthrosc Tech. .

Abstract

Massive, irreparable rotator cuff tears are a source of pain and disability. Although most rotator cuff tears can be completely repaired, a significant number are considered massive and irreparable. Numerous operative techniques have been described for the treatment of these kinds of tears including arthroscopic debridement, biceps tenotomy, tendon transfer, grafting, and reverse arthroplasty. We describe a surgical technique using a biodegradable subacromial balloon spacer (InSpace; OrthoSpace, Kfar Saba, Israel) implanted between the humeral head and acromion that permits smooth, frictionless gliding, restoring the shoulder biomechanics. The technique is easy to perform and is less invasive than the conventional surgical techniques available, and it may potentially serve as a bridging option in patients with massive, irreparable tears who are normally candidates for reverse arthroplasty.

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Figures

Figure 1
Figure 1
InSpace treatment algorithm. (ISP, infraspinatus; SSP, supraspinatus; SUBSCAP, subscapularis.)
Figure 2
Figure 2
Definition of medial point in left shoulder with patient in beach-chair position, arthroscope in posterior portal, and arthroscopic probe in lateral portal.
Figure 3
Figure 3
Definition of lateral point in left shoulder with patient in beach-chair position, arthroscope in posterior portal, and arthroscopic probe in lateral portal.
Figure 4
Figure 4
Lateral marker of spacer sheath (arrow) in left shoulder with patient in beach-chair position, arthroscope in posterior portal, and spacer sheath in lateral portal.
Figure 5
Figure 5
Assistance in spacer (balloon) deployment using probe in left shoulder with patient in beach-chair position, arthroscope in posterior portal, and arthroscopic probe in anterior portal.
Figure 6
Figure 6
(A) Partially exposed spacer and (B) fully exposed spacer in left shoulder with patient in beach-chair position, arthroscope in posterior portal, and spacer in lateral portal.
Figure 7
Figure 7
Final step of deployment and sealed spacer in left shoulder with patient in beach-chair position, arthroscope in posterior portal, and spacer in lateral portal.
Figure 8
Figure 8
Inflated spacer over humeral head in left shoulder with patient in beach-chair position, arthroscope in posterior portal, and spacer in lateral portal. The sealing mechanism is marked with an arrow.
See this image and copyright information in PMC

References

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