From the Shoulder and Elbow Unit (Garríguez-Pérez, Lópiz, García-Fernández, and Marco), Department of Traumatology and Orthopaedic Surgery (Lópiz, and Marco), Clínico San Carlos Hospital, and the Department of Surgery, Complutense University, Madrid, Spain.
J Am Acad Orthop Surg. 2022 Oct 1;30(19):e1260-e1268. doi: 10.5435/JAAOS-D-22-00025. Epub 2022 Jul 12.
Arthroscopic balloon spacer arthroplasty (BSA) is a relatively recent procedure for patients with irreparable rotator cuff tears, conceived to prevent degenerative joint changes and relieve subacromial pain.
This is a retrospective case series of 16 consecutive patients treated with BSA and followed up for a minimum 12 months. Besides BSA, partial tendon repair was done whenever possible. Radiographical parameters such as acromiohumeral distance and Hamada stage were measured preoperatively and postoperatively. Range of motion, functional results (Constant score; Simple Shoulder Test; American Shoulder and Elbow Surgeons score; and Disabilities of the Arm, Shoulder, and Hand score), health-related quality of life results with the EuroQol Five Dimensions tool, complications, and patient satisfaction were also analyzed.
The mean age was 64 ± 10.3 years, and the male/female ratio was 6/10. Partial repair was achieved in five patients (31.2%) and did not influence functional or health-related quality of life results ( P = 0.11). The mean acromiohumeral distance and Hamada stage worsened from preoperative measures (3.7 ± 2.0 mm and 2.3 ± 1.1) to final follow-up measures (3.1 ± 2.4 mm and 3.1 ± 1.3). Shoulder abduction increased by 7.8° ± 26.8° and forward flexion decreased by 25.5° ± 32.4° after surgery. The functional results at the final follow-up were Constant 49.5 ± 18.0; American Shoulder and Elbow Surgeons 60.2 ± 27.2; Simple Shoulder Test 8.5 ± 4.6; and Disabilities of the Arm, Shoulder, and Hand 32.7 ± 12.1. The mean index value for the EuroQol Five Dimensions was 0.79, and perceived quality of life was 85.6 ± 15.4 of 100 points. 62.5% of the patients (10) were satisfied with surgery. The complication rate was 13% (2), accounting for one deep infection and one balloon migration.
Theoretical benefits of BSA for delaying superior humeral head translation and arthropathic changes could not be demonstrated in our series. Its functional results and satisfaction rates are low, but self-reported quality of life after surgery does not seem impaired. Complications do not occur frequently but require reintervention and endanger joint viability.
Level IV (case series).
关节镜下球囊扩张术（BSA）是一种针对不可修复的肩袖撕裂患者的相对较新的手术方法，旨在预防退行性关节变化和缓解肩峰下疼痛。
这是一项对 16 例连续接受 BSA 治疗并至少随访 12 个月的患者进行的回顾性病例系列研究。除了 BSA，只要可能，还进行部分肌腱修复。术前和术后测量肩峰肱骨头距离和 Hamada 分期等影像学参数。还分析了活动范围、功能结果（Constant 评分、简易肩测试、美国肩肘外科医师评分和上肢功能障碍问卷）、健康相关生活质量结果（EuroQol Five Dimensions 工具）、并发症和患者满意度。
患者的平均年龄为 64 ± 10.3 岁，男女比例为 6:10。五名患者（31.2%）实现了部分修复，但这并未影响功能或健康相关生活质量结果（P = 0.11）。肩峰肱骨头距离和 Hamada 分期从术前测量值（3.7 ± 2.0 毫米和 2.3 ± 1.1）恶化至最终随访测量值（3.1 ± 2.4 毫米和 3.1 ± 1.3）。术后肩外展增加 7.8°±26.8°，前屈减少 25.5°±32.4°。最终随访时的功能结果为 Constant 49.5 ± 18.0；美国肩肘外科医师 60.2 ± 27.2；简易肩测试 8.5 ± 4.6；上肢功能障碍问卷 32.7 ± 12.1。EuroQol Five Dimensions 的平均指数值为 0.79，感知生活质量为 100 分中的 85.6 ± 15.4。62.5%（10 名）的患者对手术满意。并发症发生率为 13%（2 例），包括 1 例深部感染和 1 例球囊移位。
BSA 对延迟肱骨头向上移位和关节病变化的理论益处在我们的研究中无法得到证实。其功能结果和满意度较低，但术后自我报告的生活质量似乎没有受到影响。并发症并不常见，但需要再次干预并危及关节活力。
IV 级（病例系列）。
