{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T13:43:36Z","timestamp":1792158216466,"version":"4.4.0"},"reference-count":43,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2023,6,27]],"date-time":"2023-06-27T00:00:00Z","timestamp":1687824000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Sports Med"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>In recent years, the placement of a subacromial balloon (SAB) spacer has emerged as a treatment option for massive irreparable rotator cuff tears (MIRCTs); however, there is significant controversy regarding its utility in comparison with other surgical interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To compare outcomes after SAB spacer placement versus arthroscopic debridement for MIRCTs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Dual-armed systematic review and meta-analysis (level IV evidence).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A literature search of PubMed (MEDLINE), Scopus, and CINAHL Complete databases for articles published before May 7, 2022, was conducted to identify patients with MIRCTs undergoing the 2 procedures. For the SAB arm, 14 of 449 studies were considered eligible for inclusion, while 14 of 272 studies were considered eligible for inclusion in the debridement arm.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      In total, 528 patients were eligible for inclusion in the SAB arm and 479 patients in the debridement arm, and 69.9% of patients undergoing SAB placement also underwent concomitant debridement. Decreases in the visual analog scale (VAS) pain score and increases in the Constant score were found to be significantly larger after debridement (\u20130.7 points [\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001] and +5.5 points [\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001], respectively), although the Patient Acceptable Symptom State for the VAS was not achieved after either procedure. Both SAB placement and debridement significantly improved range of motion in forward flexion\/forward elevation, internal and external rotation, and abduction (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001). Rates of general complication were higher after debridement versus SAB placement (5.2% \u00b1 5.6% vs 3.5% \u00b1 6.3%, respectively;\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001); however, there were no significant differences between SAB placement and debridement in rates of persistent symptoms requiring a reintervention (3.3% \u00b1 6.2% vs 3.8% \u00b1 7.3%, respectively;\n                      <jats:italic>P<\/jats:italic>\n                      = .252) or reoperation rates (5.1% \u00b1 7.6% vs 4.8% \u00b1 8.4%, respectively;\n                      <jats:italic>P<\/jats:italic>\n                      = .552). The mean time to conversion to reverse total shoulder arthroplasty was 11.0 versus 25.4 months, respectively, for the SAB versus debridement arm.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>While SAB placement was associated with acceptable postoperative outcomes in the treatment of MIRCTs, there was no clear benefit over debridement alone. Shorter operative times coupled with better postoperative outcomes and longer times to conversion to reverse total shoulder arthroplasty rendered debridement a more attractive option. While there may be a role for SAB placement in poor surgical candidates, there is burgeoning evidence to support debridement alone without SAB placement for the treatment of MIRCTs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03635465231168127","type":"journal-article","created":{"date-parts":[[2023,6,27]],"date-time":"2023-06-27T16:31:16Z","timestamp":1687883476000},"page":"1088-1097","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":12,"title":["Subacromial Balloon Placement Demonstrates No Advantage Over Debridement in the Treatment of Massive Irreparable Rotator Cuff Tears: A Dual-Armed Systematic Review and Meta-analysis of Over 1000 Patients"],"prefix":"10.1177","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5784-9473","authenticated-orcid":false,"given":"Alexis B.","family":"Sandler","sequence":"first","affiliation":[{"name":"William Beaumont Army Medical Center\/Texas Tech University Health Sciences Center, El Paso, Texas, USA"},{"name":"Texas Tech University Health Sciences Center, El Paso, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis G.","family":"Gil","sequence":"additional","affiliation":[{"name":"Robbins College of Health and Human Sciences, Baylor University, Waco, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John P.","family":"Scanaliato","sequence":"additional","affiliation":[{"name":"William Beaumont Army Medical Center\/Texas Tech University Health Sciences Center, El Paso, Texas, USA"},{"name":"Texas Tech University Health Sciences Center, El Paso, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clare K.","family":"Green","sequence":"additional","affiliation":[{"name":"School of Medicine and Health Sciences, George Washington University, Washington, District of Columbia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John C.","family":"Dunn","sequence":"additional","affiliation":[{"name":"William Beaumont Army Medical Center\/Texas Tech University Health Sciences Center, El Paso, Texas, USA"},{"name":"Texas Tech University Health Sciences Center, El Paso, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nata","family":"Parnes","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Carthage Area Hospital, Carthage, New York, USA"},{"name":"Department of Orthopedics, Claxton-Hepburn Medical Center, Ogdensburg, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,6,27]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.asmr.2022.02.011"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-018-4065-x"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2018.10.013"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2017.03.029"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2006.05.009"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2020.09.048"},{"issue":"1","key":"e_1_3_2_8_2","first-page":"68","article-title":"Results after the application of biodegradable spacer balloons as a therapeutic option in non-repairable massive ruptures of the shoulder rotator cuff","volume":"66","author":"Garc\u00eda Moreno J","year":"2022","unstructured":"Garc\u00eda Moreno J, Correa Bellido P, Salazar Aguilar JR, P\u00e9rez Correa JI, Montaner Alonso D, Rodrigo P\u00e9rez JL. 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