Subacromial Balloon Implantation for the Treatment of Irreparable Posterosuperior Rotator Cuff Tears

Despite the development of various therapeutic options, surgical management of irreparable rotator cuff tears (IRCTs) remains controversial. Recently, implantation of a biodegradable subacromial balloon spacer (InSpace, Stryker Corporation; Kalamazoo, MI) has gained considerable interest for the treatment of certain IRCTs. The reported outcome of balloon implantation has not been consistent, likely due to differing indications and technical approaches. The purpose of this article is to present a reproducible arthroscopic technique for implantation of a subacromial balloon and to review the literature published to date, regarding the efficacy and outcomes of this procedure. Video 1 Detailed surgical steps of the technique described with a voiceover. The video demonstrates an arthroscopic technique for implantation of a subacromial balloon spacer (InSpace, Stryker Corporation, Kalamazoo, MI). The patient is in the beach chair position with a right-sided operative shoulder. The primary viewing portal is posterior, and the main working portal is lateral. After a routine diagnostic arthroscopy, the subacromial space is prepared with an arthroscopic shaver. The balloon is then sized and implanted through the lateral portal under direct visualization from the posterior portal. Finally, the subacromial balloon spacer (InSpace, Stryker Corporation) system is again highlighted.