Balloon Arthroplasty Surgery: Revolutionary Treatment Option Changes the Game for Massive Irreparable Rotator Cuff Tears at Bucks County Orthopedic Specialists
Shoulder Surgeon, Dr. Kieran Cody, Answers the Most Frequently Asked Questions
Before last year, if you had a massive irreparable rotator cuff tear, there were no minimally invasive surgical options to help relieve pain or restore function. But that is not the case anymore. In July 2021 the FDA approved the first balloon implant for arthroscopic treatment of irreparable rotator cuff tears – changing the game for orthopedic surgeons and their patients.
In fact, Bucks County Orthopedic Specialist (BCOS), Dr. Kieran Cody, recently became the first physician at Doylestown Hospital to perform balloon arthroplasty surgery for a massive rotator cuff tear. The results of this minimally invasive procedure were phenomenal, with decreased recovery time, and dramatically improved pain, range of motion, and strength for his patient.
Here, Dr. Cody answers common questions related to balloon arthroplasty for the shoulder.
Q: What is the rotator cuff?
Dr. Cody: The rotator cuff is a group of muscles and tendons that surround the shoulder joint and work together to provide stability and mobility to the shoulder, which is the most flexible joint in the body. The rotator cuff actually consists of 4 different muscles including the supraspinatus, infraspinatus, teres minor, and subscapularis.
Q: What is a massive irreparable rotator cuff tear? What makes it irreparable?
Dr. Cody: An irreparable tear is one that is very large and has been present for a long time, such that the muscles shrink and can no longer be stretched back to where they belong. It is characterized by a torn and retracted tendon. As a result of that retraction, mobility is severely compromised and muscle atrophy can set in.
Q: How is a massive irreparable rotator cuff diagnosed?
Dr. Cody: We diagnose this with a combination of x-ray, exam, medical history, and typically an MRI.
Q: What is balloon surgery for the shoulder?
Dr. Cody: Balloon surgery is the commonly used phrase for what we call balloon arthroplasty. This is a minimally invasive surgical procedure that is done with a very small incision. During the surgery, a balloon implant is placed in the subacromial space of the patient’s shoulder. This is located between the upper shoulder bone and the ball and socket joint.
Q: Why is a balloon implant or balloon surgery helpful for a massive irreparable rotator cuff tear?
Dr. Cody: Beyond the pain that is caused by this kind of injury, it can be difficult for patients to raise or move their arm. The space within the shoulder joint can become compressed, leading to increased pain, decreased range of motion, and more arthritis.
Q: How does the balloon arthroplasty help a patient who has pain and reduced range of motion due to an irreparable rotator cuff tear?
Dr. Cody: The balloon implant steps in to hold the space of the fluid-filled bursa that is typically damaged, inflamed, and painful when the rotator cuff’s tendons tear. Recreating the space between the shoulder and arm’s scapula, acromion, and humerus bones, the balloon implant provides long-lasting pain relief and restores range of motion.
Q: What happens in balloon arthroplasty surgery?
Dr. Cody: This is a minimally invasive procedure, so there is a small incision made. Then, using an arthroscope, I insert the balloon implant into the subacromial space of the shoulder. No internal sutures or fixative devices are required.
Q: What is the recovery from shoulder balloon arthroplasty surgery?
Dr. Cody: The patient is typically discharged the same day as the procedure, and only needs to wear a sling for 2-3 weeks.
Q: What are the benefits of shoulder balloon arthroplasty surgery?
Dr. Cody: First, it is incredible to have a minimally invasive treatment option to offer patients who are suffering from a painful condition that was previously thought to be irreparable. So, the most obvious benefit would be a decrease in pain and an increase in movement and quality of life for those patients. Also, the arthroplasty itself is a smaller procedure, a quicker surgery, and a faster recovery than a more lengthy, invasive, or complicated surgery would be.
Q: Is the shoulder balloon implant biodegradable?
Dr. Cody: Yes. The balloon itself is bioabsorbable and is reabsorbed by the body in about one year.
Q: After the shoulder balloon implant is absorbed by the body, how does the space and range of motion remain in the shoulder?
Dr. Cody: That’s the interesting thing, even after the balloon is reabsorbed in about a year, the benefits last for many years. It is thought that the shoulder retrains itself to work without the rotator cuff.
Q: Who is a good candidate for shoulder balloon surgery?
Dr. Cody: First, the patient has to have an irreparable rotator cuff tear of one or more of the four rotator cuff muscles. Second, they must have very little arthritis. If they have a lot of arthritis, they would be better treated with a shoulder replacement. Third, they need to be able to move their arm through a range of motion. If they have no ability to raise their arm, they are unlikely to regain that motion.
Q: You were the first physician at Doylestown Hospital to perform shoulder balloon arthroplasty. But how long has this technology been available?
Dr. Cody: Well, the shoulder balloon implant was approved by the FDA for use in the United States in July 2021. But this implant and procedure has been used in Europe and Israel for over a decade. So, while it is new here. It has a long, successful clinical history.
Q: How often do you see irreparable rotator cuff tears?
Dr. Cody: Well, I’m a shoulder surgeon, so I see a few every month. I am very glad to have this new technique available as an option for the right patient.
If you have shoulder pain or want more information about shoulder balloon arthroplasty, reach out to BCOS by calling 214-348-7000.