Percutaneous Subacromial Balloon Spacer Insertion Under Fluoroscopic Guidance in Patients Older Than 60 Years With...

To assess the mid-term clinical outcomes of percutaneous balloon spacer insertion in patients older than 60 years with rotator cuff arthropathy under regional anesthesia and fluoroscopic guidance.

A retrospective study was conducted. Patients older than 60 years with rotator cuff arthropathy, an American Society of Anesthesiologists (ASA) score of 3 or 4, and undergoing balloon spacer insertion under fluoroscopic guidance were included. Patients with previous rotator cuff repair/arthroscopic surgery or who did not have a trial of physical therapy prior to surgery were excluded. Range of motion, visual analog scale (VAS), Single Assessment Numeric Evaluation, and American Shoulder & Elbow Surgeons score were collected at baseline, 2 weeks, 6 months, and a minimum of 1 year postoperatively.

Seven operated shoulders (6 patients) were included in this study. The mean age was 78.1 years (range, 68-90 years). There were 5 ASA 3 patients (83%) and 1 ASA 4 patient (17%). At 2 weeks postoperation, there was significant improvement in the VAS score, from a mean (SD) of 7.7 (1.6) to 4.8 (2.6) (P = .003). At 6 months postoperation, there was significant and sustained improvement in the VAS score, with a mean (SD) of 3 (3.2) (P = .020). At a minimum of 1 year postoperatively (range 12-48 months), there was significant improvement, with a mean (SD) of 2.9 (3.0) (P = .012) in the VAS score and 67 (21) (P = .025) in the Single Assessment Numeric Evaluation score. The American Shoulder & Elbow Surgeons score improved from a mean (SD) of 44.7 (13) to 64.3 (26.5) at final follow-up but was not statistically significant. Range of motion did not significantly improve at all time points.

Percutaneous insertion of a subacromial balloon spacer results in a significant reduction of pain in patients aged 60 years and older with rotator cuff arthropathy but does not improve their function at a minimum 1-year follow-up.

Level IV, retrospective therapeutic case series.