customer service agent. She fell in the airport four months ago and has had pain and weakness, can't sleep, anti-inflammatories, no therapy, no better. Then she slipped in the bathtub about a year earlier and said she hurt her arm originally prior to that first fall. Was treated with cortisone and physical therapy and was okay until she had her fall at work. And here's her x-rays, you know, nothing really too exciting, head's well-centered, looks okay. And then here's her MRI and she's got this huge defect and not a lot of functional muscle, particularly in the back and the infraspinatus area. And so we took care of her, her subscap was intact, and here's her diagnostic arthroscopy. Biceps tendon looked okay. Shoulder was a little bit angry, a little bit red, but here's what we're looking at. We have a huge defect and there's just no cuff. We got, there's humeral head, you're seeing the acromion. There was really no rotator cuff to speak of at all in this case. And so we were dealing with a very difficult situation. Shoulder was a little bit reactive and angry and we had no rotator cuff tissue to functionally work with. And so now what do you do? What are your options? Well, this was when we were looking at, we were randomizing, we were part of the, the pivotal study for the balloon. And so I just want to kind of show this balloon case. This is going to be coming onto the market this year. So right now this is not approved by the FDA, but Stryker has purchased this technology. And before the end of 2021, this should be available for use in the United States. And JT alluded to it. This is a 10 minute type operation where basically you're putting a PLLA or PLA balloon into the subacromial space. You inflate it and you get out a judge. And so this is what it was. She was enrolled in the pivotal study. She was randomized to the implant group. And so what you do is you basically measure, decide whether you need a medium or a large, and then you go ahead and put the implant into the subacromial space. You then go ahead and inflate the balloon. And it's kind of just like inflating a breast implant. And with your scope in the back, as you start to inflate the balloon, you can watch and see as the subacromial space fills up. And once the balloon is full, you then range the arm to make sure that the balloon is stable. Literally takes 10 minutes and you can go ahead and put the balloon in. So now we're looking through the balloon. You can see the defect down below and you're done. Literally 10 minutes. And so study was completed. I recently saw her, this is actually almost a year ago for her two-year post-op. And here is her function. It was a left shoulder. And you can start to see here as we start to bring her arms up, she got her full mobility back. She's got full range of motion. She's actually quite happy. To this date, she still doesn't know. We could see that. Yeah, right? To this date, she doesn't know whether she got the balloon or not. But if you look at her range of motion, she's actually very good. And you'd think she'd have a big external rotation lag sign here. And she was actually in pretty good shape as we checked her and resisted. And she was actually fine. And she actually was in good shape. And there may be something to this. Thank you. All right, last case, JT.

customer service agent

falls and injuries

rotator cuff defect

balloon implant

FDA approval