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Rice-Body Synovitis, Foreign Body Reaction, and Rotator Cuff Failure After Subacromial Balloon Spacer Augmentation of
Matthew S Fury1, Carl M Cirino1, Alex E White1
1Department of Sports Medicine and Shoulder Surgery, Hospital for Special Surgery, New York, New York.
JBJS Case Connector
|May 26, 2023
Summary
Augmenting rotator cuff repair with a subacromial balloon spacer may cause inflammation, mimicking infection and hindering healing. This complication can lead to failed rotator cuff repair.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
Background:
- Rotator cuff repair augmentation aims to improve healing outcomes.
- Subacromial balloon spacers are used to enhance rotator cuff repair.
- Early results for balloon spacers have shown promise.
Observation:
- A 66-year-old woman experienced shoulder pain and weakness post-rotator cuff repair with a subacromial balloon spacer.
- Imaging revealed rotator cuff failure, effusion, synovitis, lymphadenopathy, and bone erosion.
- Arthroscopy showed balloon fragmentation and inflamed synovium without repairable tissue.
Findings:
- Histology confirmed inflamed, ulcerated synovium.
- Cultures were negative for infection.
- The patient presented with signs of inflammation and failed repair, not infection.
Implications:
- Subacromial balloon spacers can trigger inflammatory reactions after rotator cuff repair.
- This inflammation may be misdiagnosed as infection.
- Complications can compromise rotator cuff healing and repair integrity.
