Baller_ swbca Posted May 10, 2022 Baller_ Share Posted May 10, 2022 I have learned that many BOS members have dealt with Rotator Cuff tears. Approved by FDA July 21, this saline filled balloon is inserted instead of other tissue transplants. Biomechanics restored same day but activity is restricted for 4 weeks. Does not have the same permanent restrictions on use of the shoulder as some other repairs. My tear is too extreme and retracted be repaired by sewing parts back together. The saline filled balloon is absorbed as it is replaced by scar tissue that is managed with PT to maintain range of motion. Hoping I will be able to use the new C85 this spring. Ice went out 4 days ago. Link to comment Share on other sites More sharing options...
BigGerald3 Posted May 11, 2022 Share Posted May 11, 2022 Yep, most health plans don’t cover it yet, deemed experimental as there is no long term data. The cost will b passed on to you, not sure of the cost. Could buy some time before a shoulder arthroplasty. Link to comment Share on other sites More sharing options...
Baller_ swbca Posted May 11, 2022 Author Baller_ Share Posted May 11, 2022 @BigGerald3 I am waiting for the Insurance authorization process to run its course. The Surgeon's nurse walks that through their insurance department and says they usually can make it happen with appeals etc. "we do it all the time . . otherwise we will cover it" whatever that means. This is a skiing expense, not a medical necessity at this point, so another surgical option or doing nothing is the backup plan before I spend $25,000 or more out of pocket. I haven't had a chance to establish whether or not I can ski without it being fixed at this point. Our ice went out 1 week ago and 2 surgeons suggest I just go ski to see what happens. Another BOS skier said he skied 3 years with a torn rotator cuff. Link to comment Share on other sites More sharing options...
BigGerald3 Posted May 11, 2022 Share Posted May 11, 2022 Good luck, it won’t be near $25,000. What insurance plan? You could also enroll in a study if there is one in your area. Just some thoughts, good luck! Link to comment Share on other sites More sharing options...
Baller_ swbca Posted May 11, 2022 Author Baller_ Share Posted May 11, 2022 @BigGerald3 Made some calls, the Stryker balloon implant is covered except for a small co-pay. With a 30 year layoff from skiing, I am hoping this quick turn-around repair will last until I am out of M9. Link to comment Share on other sites More sharing options...
BigGerald3 Posted May 12, 2022 Share Posted May 12, 2022 Great! Good luck with it! Link to comment Share on other sites More sharing options...
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