PURPOSE This meta-analysis was performed systematically to evaluate the efficacy of subacromial balloon spacers for patients with massive, irreparable rotator cuff tears. METHODS Electronic databases, including Medline/PubMed, Embase and Cochrane Library, were systematically searched to identify studies evaluating the efficacy of subacromial spacers for patients with irreparable or massive rotator cuff tears. Meta-analyses were performed to pool the outcome estimates of interest, such as the total constant score (TCS) and its sub-score (pain, activities of daily living [ADL], range of motion [ROM], and strength), Oxford shoulder score (OSS), American Shoulder and Elbow Society scores (ASES) and numeric rating scale (NRS), as well as different outcomes at different time points in the follow-up period. RESULTS Ten studies with a total of 261 patients involving 270 shoulders were deemed viable for inclusion in the meta-analysis. The combined results demonstrated significant improvements in the TCS at the final follow-up (pooled mean difference = 26.4, 95% confidence intervals [CIs] 23.3 to 29.5). A sensitivity analysis and subgroup analysis, which were implemented based on two factors, different follow-up points and sub-scores (pain, ADL, ROM, and strength), revealed a consistent trend. The combined shoulder motion results demonstrated significant improvements in the forward flexion and external rotation (0° abduction) variables rather than in the abduction and external rotation (90° abduction) variables. Additionally, significant improvements in the OSS and ASES and a decrease in the NRS were observed in the middle of the follow-up period. CONCLUSION This meta-analysis indicated that subacromial balloon spacer implantation for patients with massive irreparable rotator cuff tears may achieve satisfactory outcomes between 3 months and 3 years of follow-ups. Although the short- and middle- term effect is significant, the long-term effect needs to be confirmed by large-sample randomized controlled trial. LEVEL OF EVIDENCE IV.

中文翻译：

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肩峰气囊间隔植入术治疗巨大且无法修复的肩袖撕裂的患者在随访的中短期内取得了令人满意的临床效果：一项荟萃分析。

目的这项荟萃分析是系统地进行的，以评估肩峰以下气囊垫片对巨大，无法修复的肩袖撕裂患者的疗效。方法系统地搜索了包括Medline / PubMed，Embase和Cochrane库在内的电子数据库，以鉴定评估肩峰下间隔物对无法修复或巨大的肩袖撕裂的疗效的研究。进行荟萃分析以汇总感兴趣的结果估计值，例如总恒定评分（TCS）及其子评分（疼痛，日常生活活动[ADL]，运动范围[ROM]和强度），牛津大学肩关节评分（OSS），美国肩肘关节学会评分（ASES）和数字评分量表（NRS），以及随访期间不同时间点的不同结果。结果十项研究共261例患者涉及270个肩，被认为可纳入荟萃分析。综合结果表明，在最终随访中，TCS有显着改善（合并平均差= 26.4，95％置信区间[CIs] 23.3至29.5）。敏感性分析和亚组分析是基于两个因素进行的，即不同的随访点和亚评分（疼痛，ADL，ROM和强度），显示出一致的趋势。合并的肩部运动结果表明，前屈和外旋（0°绑架）变量比外展和外旋（90°绑架）变量有了显着改善。此外，在随访的中期，观察到OSS和ASES的显着改善以及NRS的减少。结论这项荟萃分析表明，对于无法修复的巨大肩袖撕裂患者，肩峰下气囊间隔植入术可能会在3个月至3年的随访期间取得令人满意的结果。尽管短期和中期效果显着，但仍需通过大样本随机对照试验来确认长期效果。证据级别IV。