On this month’s update I wanted to highlight another emerging technology in orthopedics. One of the most difficult problems I face in my practice are massive rotator cuff tears. As I have highlighted previously on Adventist Orthopedics.com, the rotator cuff consists of four muscles that move our shoulder. Tears of the rotator lead to pain, weakness, decreased range of motion, difficulty with activities of daily living and loss of sleep. Some tears occur secondary to injury, while many occur slowly over time. Most rotator cuff tears are repairable with minimally invasive arthroscopic surgery. Some tears become too large and are not amenable to repair. Massive tears can cause pain, weakness, the humeral head (ball) can escape out of the glenoid (socket), and eventually can lead to arthritis. For a long time, these tears did not have a great surgical solution. Over the last 20-30 years, reverse total shoulder replacement gained popularity to treat massive rotator cuff tears. This requires a large incision with metal and plastic implanted in the shoulder joint. Over the last 10 years, superior capsular reconstruction has emerged as another treatment option for massive rotator cuff tears. This involves reconstructing the absent rotator cuff with a donor graft of dermis (skin) tissue. This procedure is performed arthroscopically, but is technically challenging, and requires a lengthy rehabilitation.
This leads us to the latest innovation in treatment of massive rotator cuff tears, the balloon. Originally used in Europe for the last 10-15, it was approved by the FDA for use in this country two years ago. This biodegradable implant is placed into the shoulder arthroscopically through small incisions. Once put into the shoulder it is filled with saline. It works by keeping the ball centered in the socket and prevents the bones from rubbing on each other, thereby improving range of motion, and reducing pain.
This balloon dissolves in 12 months leaving scar tissue in its place. Recent studies in the US have confirmed that the balloon is a safe and effective in treatment option for massive rotator cuff tears.
If you are having shoulder pain, please contact us to discuss your treatment options. We are here to help keep you healthy, active, and pain free.