Viswanath Aparna, Drew Steve
Dept of Orthopaedics, University Hospital Coventry and Warwickshire NHS Trust, Clifford Bridge Road, Coventry, CV2 2DX, United Kingdom.
J Clin Orthop Trauma. 2021 Mar 26;17:223-232. doi: 10.1016/j.jcot.2021.03.017. eCollection 2021 Jun.
Rotator cuff tears are a common cause of disability and pain. The ideal treatment for truly irreparable rotator cuffs is still debated, and one recent surgical advance is the development of the subacromial balloon spacer. This review aims to clarify the current evidence and indications for this device.
A comprehensive literature search was undertaken using the MeSH search terms combining "balloon spacer" and "irreparable cuff tear". A total of 20 studies using the balloon spacer as a treatment modality in more than two patients, were analysed.
A total of 513 patients were analysed, representing 83% of those initially identified as meeting the inclusion criteria. The majority of studies recommended the device, with only four suggesting it was not recommended based on their results. Notable bias was present in the studies analysed, and there were no papers providing greater than level III evidence.
The subacromial balloon spacer is one possible treatment option for older, low-demand patients with a full thickness rotator cuff tear involving only the supraspinatus tendon, who also have no arthritis and have preserved active elevation beyond 90°. However, the results of two large randomised prospective trials are awaited to provide satisfactory evidence regarding the use of the balloon spacer.
肩袖撕裂是导致残疾和疼痛的常见原因。对于真正无法修复的肩袖，理想的治疗方法仍存在争议，最近一项外科进展是肩峰下球囊间隔器的开发。本综述旨在阐明该装置的现有证据和适应症。
使用医学主题词（MeSH）检索词“球囊间隔器”和“不可修复的肩袖撕裂”进行全面的文献检索。共分析了20项对两名以上患者使用球囊间隔器作为治疗方式的研究。
共分析了513例患者，占最初确定符合纳入标准患者的83%。大多数研究推荐使用该装置，只有四项研究根据其结果表明不推荐使用。所分析的研究存在明显偏倚，且没有论文提供高于III级的证据。
肩峰下球囊间隔器是年龄较大、需求较低、肩袖全层撕裂仅累及冈上肌腱、无关节炎且主动抬高超过90°的患者的一种可能治疗选择。然而，仍有待两项大型随机前瞻性试验的结果来提供关于球囊间隔器使用的满意证据。
