46. LIVE from AOSSM: Off the Cuff - Subacromial Balloon & Biceps SMASH (Dr. Nikhil Verma & Dr. John Tokish)

Today's episode focuses on two different surgical techniques for management of complex rotator cuff injuries: (1) The biceps SMASH technique for augmentation of a repairable rotator cuff tear. (2) The subacromial balloon spacer – InSpace by Stryker – to manage irreparable rotator cuff tears. We are joined today by two distinguished guests:Dr. Nikhil Verma is the Director of the Sports Medicine Division and the Sports Medicine Fellowship at Rush , head team physician for the Chicago White Sox  and team physician for the Chicago Bulls . He will be discussing use of the Stryker InSpace balloon implant to treat irreparable posterosuperior rotator cuff tears.Dr. John Tokish is the President of the Arthroscopy Association of North America  and Director of the Sports Medicine Fellowship at Mayo Clinic in Arizona . Dr. Tokish will be speaking about the “biceps smash technique” — using long head of biceps tendon autograft to biologically augment rotator cuff repair.In this episode, we discuss:What are the benefits of using biceps autograft SMASH rather than many of the other scaffold options that are available, such as acellular dermal allograft, xenografts or other autograft tissue?How is the biceps graft harvested, prepared and then secured to the rotator cuff repair? (Check out our Instagram - @thesportsdocspod - for images of the graft preparation.)Which patients are ideal candidates for the InSpace subacromial balloon spacer? Should we be adding the balloon to rotator cuff repairs to protect the repair construct?What are some pearls and pitfalls to optimize InSpace placement and avoid complications?How do patients do after the InSpace procedure? How are the clinical outcomes compared to other treatments for MIRCTs?