{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:43:05Z","timestamp":1787755385287,"version":"build-2784847793"},"reference-count":70,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:p>\n                    <jats:list list-type=\"plain\">\n                      <jats:list-item>\n                        <jats:p>\u00bb Subacromial balloon spacer (SBS) implantation has been proposed as a minimally invasive treatment for massive irreparable rotator cuff tears (MIRCTs), particularly in elderly patients with preserved glenohumeral articulation and limited functional demands.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>\u00bb Across observational studies, SBS has been associated with short to midterm improvements in pain and shoulder function, reflected by increases in ASES and Constant-Murley scores.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>\u00bb Evidence from randomized controlled trials is mixed; the SPACE trial showed SBS is noninferior to partial repair, while the START:REACTS trial found it less effective than debridement alone.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>\u00bb Complications are uncommon and primarily include balloon migration, synovitis, and rare infections, supporting SBS's safety profile when patient selection is appropriate.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>\u00bb Based on current high-level evidence, SBS is not recommended for routine treatment of MIRCT. Its use should be restricted to carefully selected elderly patients with chronic, nonarthritic MIRCT who are poor candidates for other reconstructive procedures.<\/jats:p>\n                      <\/jats:list-item>\n                    <\/jats:list>\n                  <\/jats:p>","DOI":"10.2106\/jbjs.rvw.25.00231","type":"journal-article","created":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T19:01:04Z","timestamp":1772046064000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Limited Clinical Benefit of the Subacromial Balloon Spacer in Massive Irreparable Rotator Cuff Tears"],"prefix":"10.2106","volume":"14","author":[{"given":"Waleed","family":"Albishi","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8804-3743","authenticated-orcid":false,"given":"Mishari","family":"Alanezi","sequence":"additional","affiliation":[{"name":"College of Medicine, King Saud University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noura","family":"Alnasser","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Dr. Sulaiman AlHabib Medical Group, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalid","family":"Murrad","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emad","family":"Elansary","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6034-9739","authenticated-orcid":false,"given":"Abdulrahman","family":"Alaseem","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,2]]},"reference":[{"issue":"5","key":"r1-20260225","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1007\/s12178-020-09661-9","article-title":"Subacromial balloon spacer implantation","volume":"13","author":"Wright","year":"2020","journal-title":"Curr Rev Musculoskelet Med"},{"issue":"1","key":"r2-20260225","doi-asserted-by":"crossref","first-page":"71","DOI":"10.2106\/00004623-200101000-00010","article-title":"Surgical repair of chronic rotator cuff tears. 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