A Biomechanical Study Examining The Subacromial Balloon Spacer and Superior Capsular Reconstruction in the Treatment of Massive, Irreparable Rotator Cuff Tears

Rotator cuff tears are common tendon injuries and can be a major source of pain and disability. Massive, irreparable rotator cuff tears are a challenging surgical dilemma as currently there is no gold standard treatment algorithm. Multiple possible treatment options exist yet no clear guidelines for optimal surgical technique for this disorder have been established. In this study, two new techniques described in the treatment of massive, irreparable rotator cuff tears were explored; the insertion of a subacromial balloon spacer and superior capsular reconstruction. Their ability to restore glenohumeral joint kinematics was examined in cadaveric specimens with surgically created massive, irreparable rotator cuff tears. Humeral head migration and functional abduction forces were the outcomes measured. Both the subacromial balloon spacer and the superior capsular reconstruction were effective at restoring humeral head position at varying degrees of abduction as compared to the intact shoulder state. Functional abduction force was also restored with both surgical techniques. Finally, the subacromial balloon filled from 10-25 mL proved to be the most effective in restoring humeral head positioning. Further clinical studies need to be performed to determine if these results are reproducible in vivo as well as in the long term