Biodegradable subacromial spacer insertion for rotator cuff tears

1 Draft recommendations

1.1 When debridement is a suitable option, biodegradable subacromial spacer insertion for rotator cuff tears should not be used. Find out why NICE recommends not to use some procedures on the NICE interventional procedures guidance page.

1.2 When debridement is not a suitable option, biodegradable subacromial spacer insertion for rotator cuff tears should be used only in research. Find out what only in research means on the NICE interventional procedures guidance page.

1.3 Further research should report details of patient selection, measures of shoulder function, pain relief and quality of life. Follow up should ideally be for a minimum of 2 years.

1.4 Patient selection should be done by a multidisciplinary team experienced in managing the condition, including clinicians with specific training in the procedure.

1.5 The procedure should only be done by surgeons with specific training in inserting the device.

Why the committee made these recommendations

Good quality evidence from the UK shows that symptoms including shoulder dysfunction and pain may be worse after this procedure compared with after debridement (removing damaged tissue from around the shoulder joint). So, the procedure should not be used when debridement is a suitable option.

It is not clear from the evidence if the procedure is beneficial for people with rotator cuff tears when debridement is not suitable. The evidence does not suggest any major safety concerns but evidence on long-term safety and benefit is limited. So, when debridement is not a suitable option, this procedure should be used only in research.