UAB Orthopaedics offers new treatment option for rotator cuff injury

The new procedure uses a balloon to separate bones in the shoulder, reducing pain and allowing physical therapy a chance to work.
Written by Emma Shepard
Media contact: Bob Shepard

Brabston Casp Momaya 01From left: Will Brabston, M.D.. Aaron Casp, M.D., Amit Momaya, M.D., UAB Department of Orthopaedic Surgery.A massive and irreparable rotator cuff tear is a diagnosis that no patient, especially an active patient, wants to receive. Now orthopaedic physicians at UAB Medicine offer a new procedure that has the ability to bring relief for patients with a massive rotator cuff tear previously deemed irreparable.

Amit Momaya, M.D., section chief of Sports Medicine in the University of Alabama at Birmingham Department of Orthopaedic Surgery, along with assistant professors Aaron Casp, M.D., and Will Brabston, M.D., have introduced the subacromial balloon spacer procedure for relief of massive irreparable rotator cuff tears.

The rotator cuff is a collection of four muscles that help stabilize and move the shoulder joint.

Minor tears may heal on their own; but any significant, or full, rotator tear usually requires surgical treatment to heal. In some cases, the tear is so massive that even surgical treatment cannot repair the rotator cuff.

When performing a subacromial balloon spacer technique, the surgeon first clears and prepares the area around the rotator cuff tear. The surgeon then inflates a small balloon, between the humeral head — the top of the humerus that fits into the shoulder joint — and the roof acromion, above the shoulder joint.

The space created by the balloon between the humeral head and the acromion, which is the bony tip of the outer edge of the shoulder blade, is the key to pain relief for patients with massive rotator cuff tears. The balloon acts as a natural barrier between the humeral head and the acromion, pushing lightly down on the humeral head to avoid contact with the acromion. Otherwise, when patients lift their shoulder, the humeral head pinches on the roof, which may cause significant pain.

balloon orthoThe balloon spacer cushions bone-on-bone impacts in severe cases of rotator cuff injury.After the balloon spacer procedure, patients can safely rehabilitate their shoulder through physical therapy. Eventually, the balloon will dissolve. Many patients still report pain relief even after the balloon dissolves, possibly due to the effects of quality physical therapy sessions while the balloon was in place.

The team has successfully performed the procedure for three cases with positive outcomes.

Before performing the procedure at UAB, Momaya, Casp and Brabston led a systematic review of the procedure across the United States. That provided valuable insights about the patient experience and outcomes associated with the procedure to ensure its efficacy for patients.

“We’re proud to offer this new technology that helps our patients with serious injuries function a little better,” Casp said. “Massive rotator cuff tears are difficult to treat, and this option is opening more doors to return to activity for our patients.”