Subacromial Balloon Interpositional Arthroplasty for the Management of Irreparable Rotator Cuff Tears: Five-year Results

Nik I Bakti1, *, Mahendar Bhat1, Bijayendra Singh1, Abhinav Gulihar2, Vellala R Prasad3
1 Department of Trauma & Orthopaedics, Medway NHS Foundation Trust, Windmill Road, Gillingham, Kent, ME7 5NY, UK
2 Department of Trauma & Orthopaedics Princess Royal University Hospital Farnborough Common Orpington, Kent BR6 8ND, UK
3 Department of Trauma & Southmead Hospital, Bristol, Bristol, BS10 5NB, UK



Management of massive irreparable rotator cuff tears can be as source of significant dilemma for the treating surgeon. This is especially true when dealing with patients with poor physiological reserves where options of tendon transfer, superior capsular repair or arthroplasty might be unsuitable. We report the five-year outcomes of 26 patients who underwent balloon interpositional arthoplasty for the management of massive irreparable rotator cuff tears.


Fifty-four consecutive patients underwent balloon interpositional arthroplasty in our institution. Of these, 26 patients completed at least two postoperative functional outcome measures over a five-year period, which included the visual analogue score (VAS), Oxford shoulder score (OSS) and the SF12 score. Outcome scores were obtained prospectively.


The average age at implantation was 67 years old. Our result shows statistically significant improvement in pain up to five years post-implantation of the device (p = 0.012). Function measured by the OSS and SF12 (PCS) score showed improvement up to two years post-implantation (p = 0.006). Three of the 54 patients in our cohort went on to have arthroplasty surgery for their rotator cuff tears. None of the patients in our cohort suffered from any adverse reactions following implantation.


Results from our study identify the spacer device as an option in the management of irreparable rotator cuff tears with statistical improvement in pain and function. It may also delay the need for arthoplasty surgery.

Keywords: Balloon, Irreparable, Massive, Rotator Cuff Tear, Subacromial Spacer, Shoulder.

Abstract Information

Identifiers and Pagination:

Year: 2019
Volume: 13
Publisher Item Identifier: EA-TOORTHJ-2018-71

Article History:

Received Date: 17/10/2018
Revision Received Date: 20/01/2019
Acceptance Date: 18/02/2019
Print publication date: 04/03/2019
Collection year: 2019

© 2019 Bakti et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: ( This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Correspondence: Address correspondence to this author at the Medway NHS Foundation Trust, Windmill Road, Gillingham, Kent, ME7 5NY, UK; Tel: +44 1634 830000; E-mail: