A 60 year old weight lifter presented with pain and stiffness in his right shoulder. He desired a ream and run procedure to avoid the limitations and risks of the prosthetic glenoid component used in total shoulder arthroplasty. His preoperative x-rays show osteoarthritis with posterior humeral head decentering on a biconcave glenoid
CT scans and preoperative planning were not needed. A general anesthetic was used without a brachial plexus block. At surgery some excessive intraoperative posterior translation was manged with a rotator interval plication. See How to do a ream and run arthroplasty.
Seven years after his ream and run he reported,
“I have long since resumed a normal life, essentially forgetting I ever had a problem.
The years leading up to surgery, when I could no longer ride a bike, kayak, rock climb, lift weights or even play the piano because I couldn’t raise my right arm high enough, seem now like just a bad dream. Before discovering the R&R option, I had consulted two other orthopedic surgeons and had not been encouraged by what they had to say. Consequently, I let my shoulder problem (osteoarthritis) progress until it was no longer tolerable. At the end, I was in constant pain, occasionally severe, and a right arm that was virtually useless.
After several months of regular stretching exercises, dedicated work, not without pain, I began to realize the results of the R&R procedure. A year after surgery, I returned to the gym for the first time in twenty-five years. It was a new lease on life. Now, I exercise pretty vigorously three to five times a week, working all muscle groups, with a goal of restoring strength, flexibility and symmetry. Climbing, biking and kayaking are no problem. I can’t seem to perform as well in the gym as I did forty years ago, but I’ve been told the problem may be related to being 68 years old, rather than 28.”
His x-rays at seven years after the ream and run show a secure impaction grafted stem with a regenerated radiographic space between his humeral head and the glenoid
He was able to perform all 12 functions of the Simple Shoulder Test and do pull-ups.
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