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Our experience balloon

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Our experience balloon

  1. 1. Emmanouil Brilakis Trauma & Orthopaedic Surgeon Athens, Greece June 26th - 2015 Department of Shoulder Arthroscopy & Surgery
  2. 2. Emmanouil Brilakis Trauma & Orthopaedic Surgeon Athens, Greece June 26th - 2015 I declare that I have no financial arrangement or affiliation with any corporate organization offering financial support or grant for this presentation, nor I do have a financial interest in any commercial product(s) or services I will discuss in the following presentation. Department of Shoulder Arthroscopy & Surgery
  3. 3. The use of a biodegradable sub-acromial spacer for the management of rotator cuff tears. Our experience www.shoulder.gr
  4. 4. The use of a biodegradable sub-acromial spacer for the management of rotator cuff tears. Our experience Biodegradable Co-polymer (Poly L-lactide-co-ε-caprolactone) Inflated with normal saline Small (40 x 50 mm) Medium (50 x 60 mm) Large (60 x 70 mm) www.shoulder.gr
  5. 5. The use of a biodegradable sub-acromial spacer for the management of rotator cuff tears. Our experience www.shoulder.gr
  6. 6. The use of a biodegradable sub-acromial spacer for the management of rotator cuff tears. Our experience www.shoulder.gr
  7. 7. The use of a biodegradable sub-acromial spacer for the management of rotator cuff tears. Our experience www.shoulder.gr
  8. 8. The use of a biodegradable sub-acromial spacer for the management of rotator cuff tears. Our experience How did we started with balloon? www.shoulder.gr
  9. 9. Three individuals interaction The use of a biodegradable sub-acromial spacer for the management of rotator cuff tears. Our experience www.shoulder.gr
  10. 10. The use of a biodegradable sub-acromial spacer for the management of rotator cuff tears. Our experience www.shoulder.gr
  11. 11. Ljubljana – Slovenia – April 2013 The use of a biodegradable sub-acromial spacer for the management of rotator cuff tears. Our experience www.shoulder.gr
  12. 12. The use of a biodegradable sub-acromial spacer for the management of rotator cuff tears. Our experience www.shoulder.gr
  13. 13. The use of a biodegradable sub-acromial spacer for the management of rotator cuff tears. Our experience www.shoulder.gr
  14. 14. Athens – Greece – 21th October 2014 The use of a biodegradable sub-acromial spacer for the management of rotator cuff tears. Our experience www.shoulder.gr
  15. 15. Athens – Greece – 21th October 2014 The use of a biodegradable sub-acromial spacer for the management of rotator cuff tears. Our experience www.shoulder.gr
  16. 16. The use of a biodegradable sub-acromial spacer for the management of rotator cuff tears. Our experience Since then… 2014 OCT MAY 2015 Short term results 7 months period www.shoulder.gr
  17. 17. The use of a biodegradable sub-acromial spacer for the management of rotator cuff tears. Our experience 22 Balloons Implanted 7 months Max Follow-up www.shoulder.gr
  18. 18. The use of a biodegradable sub-acromial spacer for the management of rotator cuff tears. Our experience 22 Balloons Implanted 7 months Max Follow-up  10 Males (45%) – 12 Females (55%)  Mean age of 64 ± 8.2 years (range, 48-81)  18 shoulders (82%) were right and 4 (18%) were left  The dominant side was involved in 18 patients (82%) Patients Demographics www.shoulder.gr
  19. 19. The use of a biodegradable sub-acromial spacer for the management of rotator cuff tears. Our experience 22 Balloons Implanted 7 months Max Follow-up  18 Massive Rotator Cuff Tears  4 Medium Size Rotator Cuff Tears www.shoulder.gr
  20. 20. The use of a biodegradable sub-acromial spacer for the management of rotator cuff tears. Our experience Medium Size Rotator Cuff Tears 4 cases During the rehabilitation: No pain (amazingly painless patients) Very few limitations in ROM Very satisfied patients www.shoulder.gr
  21. 21. The use of a biodegradable sub-acromial spacer for the management of rotator cuff tears. Our experience Medium Size Rotator Cuff Tears 4 cases Average VAS Rest Motion Night 2.0 5.5 5.8 0.0 0.2 0.0 Parameter Pre-op Post-op www.shoulder.gr
  22. 22. The use of a biodegradable sub-acromial spacer for the management of rotator cuff tears. Our experience Medium Size Rotator Cuff Tears 4 cases Parameter Pre-op ROM FF ER side ER 90 abd IR 155.0 76.3 65.0 L1 Post-op 180.0 90.0 90.0 Th10 www.shoulder.gr
  23. 23. The use of a biodegradable sub-acromial spacer for the management of rotator cuff tears. Our experience Medium Size Rotator Cuff Tears 4 cases Parameter Pre-op Function Constant ASES Oxford 38 60 14 Post-op 83 98 46 www.shoulder.gr
  24. 24. The use of a biodegradable sub-acromial spacer for the management of rotator cuff tears. Our experience Female - 68yo Medium size rotator cuff tear Revision due to anchor disengagement Treated by removal of the anchor and balloon implantation Case report www.shoulder.gr
  25. 25. The use of a biodegradable sub-acromial spacer for the management of rotator cuff tears. Our experience Case report 6 month post-op Re-operated because of pain and limited ROM No pain immediately after the operation www.shoulder.gr
  26. 26. The use of a biodegradable sub-acromial spacer for the management of rotator cuff tears. Our experience Pain free Full active ROM Good Function Constant:81, ASES: 94.99, Oxford: 47 Good strength 4Kgr – Constant Very Satisfied Case report 4 months post-op www.shoulder.gr
  27. 27. The use of a biodegradable sub-acromial spacer for the management of rotator cuff tears. Our experience 6 cases with irreparable cuff tears treated by balloon implantation only 10 cases treated with partial repair augmented by balloon implantation 1 case treated with complete repair augmented by balloon implantation 1 revision balloon case due to balloon failure treated by revision balloon implantation Massive Rotator Cuff Tears 18 cases www.shoulder.gr
  28. 28. The use of a biodegradable sub-acromial spacer for the management of rotator cuff tears. Our experience Massive Rotator Cuff Tears 18 cases During the rehabilitation: No pain or very slight pain Very satisfied patients Most have good active ROM They declare that their life quality has change www.shoulder.gr
  29. 29. The use of a biodegradable sub-acromial spacer for the management of rotator cuff tears. Our experience Massive Rotator Cuff Tears 18 cases Average VAS Rest Motion Night 1.5 5.4 7.4 0.0 0.9 0.0 Parameter Pre-op Post-op Average follow-up: 3.7 months www.shoulder.gr
  30. 30. The use of a biodegradable sub-acromial spacer for the management of rotator cuff tears. Our experience Massive Rotator Cuff Tears 18 cases Parameter Pre-op Post-op ROM FF ER side ER 90 abd IR 119.4 48.8 48.2 L1 145.4 63.8 54.2 Th11 Average follow-up: 3.7 months www.shoulder.gr
  31. 31. The use of a biodegradable sub-acromial spacer for the management of rotator cuff tears. Our experience Massive Rotator Cuff Tears 18 cases Parameter Pre-op Post-op Function Constant ASES Oxford 44.2 50.8 28.6 51.6 81 42.2 Average follow-up: 3.7 months www.shoulder.gr
  32. 32. The use of a biodegradable sub-acromial spacer for the management of rotator cuff tears. Our experience Massive Rotator Cuff Tears 18 cases All patients had: Significant pain relief Increased ROM Smooth rehabilitation www.shoulder.gr
  33. 33. The use of a biodegradable sub-acromial spacer for the management of rotator cuff tears. Our experience Massive Rotator Cuff Tears 18 cases It’s about QUALITY and not QUANTITY. The basic rule of life. www.shoulder.gr
  34. 34. The use of a biodegradable sub-acromial spacer for the management of rotator cuff tears. Our experience It’s about QUALITY www.shoulder.gr
  35. 35. The use of a biodegradable sub-acromial spacer for the management of rotator cuff tears. Our experience 2 months post operatively www.shoulder.gr
  36. 36. The use of a biodegradable sub-acromial spacer for the management of rotator cuff tears. Our experience 1 month post operatively www.shoulder.gr
  37. 37. The use of a biodegradable sub-acromial spacer for the management of rotator cuff tears. Our experience 7 days post-operatively www.shoulder.gr
  38. 38. The use of a biodegradable sub-acromial spacer for the management of rotator cuff tears. Our experience How the balloon works ? Pre-operatively Post-operatively www.shoulder.gr
  39. 39. The use of a biodegradable sub-acromial spacer for the management of rotator cuff tears. Our experience How the balloon works ? www.shoulder.gr
  40. 40. The use of a biodegradable sub-acromial spacer for the management of rotator cuff tears. Our experience How the balloon works ? www.shoulder.gr
  41. 41. The use of a biodegradable sub-acromial spacer for the management of rotator cuff tears. Our experience Male - 62yo - Doctor Massive rotator cuff tear after shoulder dislocation (first) Treated by arthroscopic complete repair Revision arthroscopy (1st) due to pain and limited ROM Anchor disengaged – failed repair Treated by balloon implantation Revision arthroscopy (2nd) due to balloon failure Treated by revision balloon implantation Case report www.shoulder.gr
  42. 42. The use of a biodegradable sub-acromial spacer for the management of rotator cuff tears. Our experience Case report Blood tests were negative for infection www.shoulder.gr
  43. 43. The use of a biodegradable sub-acromial spacer for the management of rotator cuff tears. Our experience Case report www.shoulder.gr
  44. 44. The use of a biodegradable sub-acromial spacer for the management of rotator cuff tears. Our experience Case report www.shoulder.gr
  45. 45. The use of a biodegradable sub-acromial spacer for the management of rotator cuff tears. Our experience Case report During arthroscopy: Empty balloon Pierced at scope introduction ? Debris and synovitis Hundreds of white debris 1mm in diameter inside joint and sub-acromialy. www.shoulder.gr
  46. 46. www.shoulder.gr The use of a biodegradable sub-acromial spacer for the management of rotator cuff tears. Our experience
  47. 47. www.shoulder.gr The use of a biodegradable sub-acromial spacer for the management of rotator cuff tears. Our experience In conclusion: Very easy technique with Promising initial results
  48. 48. www.shoulder.gr The use of a biodegradable sub-acromial spacer for the management of rotator cuff tears. Our experience …for your attentionThank you!

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