The most recent thing that has been invented is that there’s no screw at all attached to the suture. It’s all suture. And the trick is, the suture goes in small, and then it balls up underneath the bone and it can’t be pulled out because its surface area widens, and it spreads out. It not only takes up a lot less of the bone, it displaces less of the bone as well. This is an all-suture anchor.
Engineers have even invented knotless all-suture anchors. Instead of us having to tie a knot, and the knot can in some cases cause some irritation, when you have a knotless anchor, it’s basically a low-profile implant that doesn’t rub on anything in your shoulder. It’s a more natural profile of your labrum that gets repaired, with no knot sticking up on top of the labrum that can cause irritation.
The next newest thing is called the InSpace balloon. This balloon is inserted in a deflated state through poke holes, and once you put it in the shoulder, its’ inflated with sterile saline water. What this does is cushion the ball of the shoulder from hitting the shoulder blade bone. So, it cushions the ball from rubbing against the bone. This is for people that have a large retracted or a massive retracted rotator cuff tear that can’t be repaired. Instead of trying to repair that tendon, which we know will probably not work, instead they put a balloon in and it cushions the ball from rubbing against the shoulder blade bone.
The other option for those massive tears is the reverse shoulder. If you can’t repair the rotator cuff, then one of the common procedures to help the patient lift their arm is the reverse shoulder replacement. Basically, patients with a massive rotator cuff tear that’s not repairable will be presented with several options, one of which is the reverse shoulder replacement, and then the newest option is the InSpace balloon.
They’re two very different procedures. One is an incision in the front of the shoulder, where metal or plastic are put in the shoulder as a replacement, and the other is a balloon that is put through small poke holes. They’re very different procedures, but they are designed to fix the same problem, which is a large rotator cuff tear.