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Background <p>Irreparable and critically reparable injuries of the superior rotator cuff continue to represent a therapeutic challenge. A&#xa0;joint-sparing and operatively relatively simple treatment option is arthroscopic implantation of a subacromial spacer (the InSpace balloon; Stryker, Portage, MI, USA).</p> Objective <p>The aim of this study is to compare pre- and postoperative clinical data to examine the effectiveness of the InSpace balloon and evaluate the indication.</p> Materials and methods <p>In a specialized shoulder and elbow center, 27&#xa0;consecutive patients who underwent shoulder arthroscopy with implantation of a&#xa0;subacromial spacer between 2017 and 2022 were included in the study; 21&#xa0;patients were followed up between March and April 2022. The average follow-up duration was 18.6&#xa0;months. Alongside medical history, pre- and postoperative pain (numeric rating scale, NRS), Constant score, American Shoulder and Elbow Surgeons (ASES) score, and range of motion (RoM) were measured and compared.</p> Results <p>In overall cohort, the mean NRS for pain changed significantly from 5&#xa0;to 3&#xa0;(<i>p</i> = 0.004), the Constant score improved significantly from 47.55 to 57.25 (<i>p</i> = 0.018), and the ASES score improved significantly from 47.9 to 61.1 (<i>p</i> = 0.01). Regarding RoM, only external rotation improved significantly from 50.9 to 60&#xa0;° (<i>p</i> = 0.001). The subanalysis comparing patients with a&#xa0;prior operation to those without showed that only patients without prior operation benefitted. In the cohort with short-term follow-up (under 2&#xa0;years) there was a&#xa0;significant change in NRS (<i>p</i> = 0.002) and ASES score (<i>p</i> = 0.02) but not in the Constant score. There were no significant changes of measurement parameters in the cohort with mid-term follow-up (over 2&#xa0;years).</p> Conclusion <p>Surgery with InSpace ballon implantation reduces pain levels. It remains unclear whether it is the medical device or the arthroscopic debridement and tenotomy/tenodesis of the long biceps tendon that is responsible for the improvement. The improvement is greatest in short-term follow-up (under 2&#xa0;years) and in patients without a previous operation.</p>

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Subakromialer Spacer zur Behandlung der nicht- rekonstruierbaren Supraspinatussehnenruptur

  • 期刊论文

  • 发表日期：

    2026年4月23日

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  • Lars Eden,
  • Anastasia Stark,
  • Tarek Maktabi,
  • Artem Malchowetski,
  • Richard Stangl

摘要

Background

Irreparable and critically reparable injuries of the superior rotator cuff continue to represent a therapeutic challenge. A joint-sparing and operatively relatively simple treatment option is arthroscopic implantation of a subacromial spacer (the InSpace balloon; Stryker, Portage, MI, USA).

Objective

The aim of this study is to compare pre- and postoperative clinical data to examine the effectiveness of the InSpace balloon and evaluate the indication.

Materials and methods

In a specialized shoulder and elbow center, 27 consecutive patients who underwent shoulder arthroscopy with implantation of a subacromial spacer between 2017 and 2022 were included in the study; 21 patients were followed up between March and April 2022. The average follow-up duration was 18.6 months. Alongside medical history, pre- and postoperative pain (numeric rating scale, NRS), Constant score, American Shoulder and Elbow Surgeons (ASES) score, and range of motion (RoM) were measured and compared.

Results

In overall cohort, the mean NRS for pain changed significantly from 5 to 3 (p = 0.004), the Constant score improved significantly from 47.55 to 57.25 (p = 0.018), and the ASES score improved significantly from 47.9 to 61.1 (p = 0.01). Regarding RoM, only external rotation improved significantly from 50.9 to 60 ° (p = 0.001). The subanalysis comparing patients with a prior operation to those without showed that only patients without prior operation benefitted. In the cohort with short-term follow-up (under 2 years) there was a significant change in NRS (p = 0.002) and ASES score (p = 0.02) but not in the Constant score. There were no significant changes of measurement parameters in the cohort with mid-term follow-up (over 2 years).

Conclusion

Surgery with InSpace ballon implantation reduces pain levels. It remains unclear whether it is the medical device or the arthroscopic debridement and tenotomy/tenodesis of the long biceps tendon that is responsible for the improvement. The improvement is greatest in short-term follow-up (under 2 years) and in patients without a previous operation.