Innovative Procedure Fixes Torn Rotator Cuffs
Balloon implant procedure restores shoulder function
Balloon implant procedure restores shoulder function
You feel it each time you swing a golf club or reach up to comb your hair. A rotator cuff tear can cause a deep ache in your shoulder. This pain may come from age, repeated use or injury. Often the pain does not get better with rest, exercise or medicine.
Rotator cuff tears have traditionally been repaired with complex shoulder surgery requiring weeks, even months, of recovery. Some tears are irreparable and can cause ongoing pain and limit shoulder movement.
Fortunately, new surgical techniques have improved treatment options. One relatively new treatment is the InSpace balloon implant for irreparable rotator cuff tears.
This technique is especially helpful for older adults who may not handle more invasive surgeries well. Studies show it can reduce symptoms and help improve function during rehabilitation.
“This innovative treatment has proven to be a beneficial alternative for patients who otherwise had few options due to the severity of their injury or how they might tolerate surgery and the recovery process,” says Brian Rebolledo, MD, an orthopedic surgeon at Scripps Clinic Torrey Pines. “Patients with irreparable tears now have an option to achieve excellent pain relief and improved function.”
Dr. Rebolledo was one of the first orthopedic surgeons in San Diego County to perform the shoulder balloon procedure, which was approved by the U.S. Food and Drug Administration in 2021.
Rotator cuff injuries
The rotator cuff is made up of muscles and tendons that attach to the shoulder bones and is key for moving the shoulder.
Rotator cuff injuries are common, especially in athletes and older adults. They can result from wear and tear or sudden injuries. If not treated, these injuries can get worse over time. Early diagnosis and treatment are crucial for the best results.
Nonsurgical treatments can help many patients feel less pain and move better. However, doctors might recommend surgery for those with constant pain, especially true for people who frequently use their arms for overhead tasks or sports.
Balloon implant vs traditional surgery
The InSpace balloon implant is an arthroscopic procedure, a type of surgery that uses small incisions. An arthroscope is a camera that helps the surgeon.
During the procedure, a small balloon is placed in the subacromial space, which is between the top of the shoulder and the ball-and-socket joint.
Next, the balloon is filled with saline solution. This creates a cushion that helps reduce soft tissue impingement. It also improves how the shoulder moves and can lead to better motion, function and pain relief.
The balloon implant is made from biodegradable material. This allows the shoulder to heal naturally without leaving permanent objects inside.
Traditional rotator cuff surgery involves stitching or patching torn areas. In many cases, it also reattaches the tendon to the humerus, or upper arm bone. The goal is to help the tendons heal back onto the bone. However, this may not be possible if the injury has worsened over time. Traditional surgery often involves a long recovery process.
“The balloon spacer procedure is different from typical rotator cuff surgery. It does not involve repairing torn tendons. Instead, the balloon fills the space where the rotator cuff is missing and prevents friction against the acromion or bone above the shoulder. This also optimizes the shoulder position for the patient’s other muscles can take over,” Dr. Rebolledo says.
With the spacer in place, the patient can train other muscles, like the deltoid, to help offset for the torn tendons. This allows the shoulder to adjust and regain function. The biodegradable balloon is absorbed by the body in 12 months.
“By the time the balloon has biodegraded, the shoulder has learned to compensate and regain function,” Dr. Rebolledo says.
Recovery process
Many patients feel less pain and see better shoulder function about four weeks after the balloon spacer procedure. In contrast, traditional open surgery usually needs a recovery time of three to six months.
No matter the treatment, physical therapy is very important. It helps strengthen surrounding muscles, restore movement and support long-term recovery.
Who’s a candidate?
The FDA-approved balloon implant is for patients with irreparable rotator cuff tears. It is particularly suited for older adults with degenerative tears.
While this treatment helps patients who cannot have traditional surgery, each case is carefully evaluated. Surgeons rely on imaging tests, such as MRI or X-rays, and a physical exam to assess shoulder structure and function.
“The decision to proceed with the balloon implant procedure depends on a full review of the patient's health and the specific shoulder condition,” Dr. Rebolledo says.
Scripps is consistently at the forefront of new technology and U.S. News & World Report’s latest Best Hospitals list ranks its orthopedic care specialty as one of the best in the nation.