Patients with irreparable rotator cuff tears have new option with subacromial spacer
BALTIMORE - MedStar Health has become the first health system in the greater Baltimore region to offer patients with massive, irreparable rotator cuff tears, a new arthroscopic approach using a balloon spacer device to cushion the shoulder socket after a rotator cuff tear. On Monday November 29, 2021, Dr. Anand Murthi treated a 65-year-old woman with the procedure that was performed in less than two hours. The patient went home the same day.
Dr. Murthi inserted the balloon device into the subacromial space located in the shoulder between the upper shoulder bone and the ball-and-socket joint underneath and filled it with saline. The implant mimics the fluid-filled bursa, the natural cushion in the shoulder, which becomes enflamed and painful after a tear.
Almost two million people visit doctors’ offices because of torn rotator cuff injuries, which most commonly occur in the dominant arm and are one of the most common sports medicine injuries.
“Athletes are at particular risk for a rotator cuff injury,” said Dr. Murthi, director of shoulder and elbow-surgery for the MedStar Orthopaedic Institute at MedStar Union Memorial Hospital. “But it can affect anyone whose job or activities require a repetitive overhead motion.”
The inflatable device has been used to treat over 29,000 severe rotator cuff tears over the past ten years in Europe, but it has only been approved by the federal Food and Drug Administration in the U.S. last summer. It’s recommended for patients over 65 who have suffered large, irreparable tears where the tendon has torn and retracted, or whose tear would be impossible to reconnected to the head of the upper arm's humerus bone.
Patients experience pain relief with this approach because the balloon blocks the humeral head from rubbing with the acromion and forces the humeral head in a more natural position and improves the joint motion.
The biodegradable balloon will be resorbed in the body over time, giving patients time to heal and strengthen muscles around the injured rotator cuff.
“Sometimes patients over 65 with degenerated bone conditions are poor candidates for the standard reattachment surgery for repairing rotator cuff tears. The surgery and the recovery both are challenging,” Dr. Murthi said.
“Current strategies treating massive irreparable rotator cuff tears often present a challenge to surgeons and may require a long and frustrating recovery,” Dr. Murthi added. This new device uses a biodegradable implant which makes me very proud to be able to offer it to our patients. Only a small opening is made to implant it, using a long arthroscopic tube, scope so the recovery is much easier.”