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Shoulder Arthritis / Rotator Cuff Tears: causes of shoulder pain: Ream and run – return to the gym

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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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