The treatment of irreparable massive rotator cuff tears with inspace balloon: rational and medium-term results.

BACKGROUND AND AIM: The treatment of irreparable massive rotator cuff tears (MIRCTs) represents a challenge for the orthopedic surgeon both for the affected population and for the intrinsic characteristics of the injury. There are different types of treatment ranging from bursectomy to reverse shoulder prosthesis and subacromial spacers. The aim of the work is to establish the clinical and functional improvement of patients treated with subacromial spacer. METHODS: we conducted 2 studies: the first analyzing a sample of 24 patients (14 females and 10 male, mean age 65.7 years) operated between 2015 and 2017 whose last follow up dates back to October 2021 and a second one analyzing 55 patients (including patients of the first sample) (30 females and 25 males, mean age 64 years) over a period of time from 2015 to 2021. The mean follow up was 56 months. All patients were diagnosed with irreparable massive rotator cuff  tears and treated with subacromial spacer. RESULTS: the result in both studies was an increase of Constant score, tripled from the pre-operative values, in ROM, doubled, and a reduction of VAS. CONCLUSIONS: the clinical results are encouraging and the use of the subacromial spacer could be a valid surgical alternative for patients with MIRCTs.  However, we needed randomized trials with long-term follow-up.

A vascular lesion in hip revision arthroplasty: a case report.

Vascular injuries during hip revision surgery can be life-threatening complications for patients. There are many aspects to consider when approaching this type of surgery for an optimal diagnostic and therapeutic strategy, as a careful planning with extensive preoperative investigations, a full attention during the surgical procedure and the use of suitable material for a proper treatment. This kind of surgery can require a dedicated and trained multidisciplinary team. We report a case of an acute intraoperative vascular lesion during an acetabular revision performed in a 55-years-old patient.