Subacromial Balloon Spacer: When to Use This?

The subacromial balloon spacer is a novel treatment option for the management of massive irreparable rotator cuff tears. This device is introduced into the glenohumeral joint and acts to alleviate the acromiohumeral impingement, caused by the massive irreparable rotator cuff tear. The device also redistributes the tension around the adjacent muscles in the joint, allowing them to compensate for the torn rotator cuff tendons. By doing so, the balloon can act as a "rehabilitation accelerator", ultimately resulting in improved shoulder pain and function. Adherence to balloon indications when selecting the appropriate patient is necessary, and these include an irreparable posterosuperior rotator cuff tear, with preserved subscapularis function, minimal to no osteoarthritis, and the ability to forward flex to 90 degrees. Clinical studies have demonstrated promising potential regarding the benefit of the balloon, with numerous studies demonstrating great outcomes after its implantation. Nevertheless, future research remains necessary to render the evidence behind its utility unequivocal.