Sunday, July 8, 2012

Ream and Run, Total shoulder, Reverse total shoulder, CTA arthroplasty

There are a variety of shoulder joint replacement procedures for the management of the different types of shoulder arthritis, including degenerative joint disease (osteoarthritis) and chondrolysis.
For individuals with rheumatoid arthritis, there may be some special concerns regarding medication around the time of surgery.
These include
A total shoulder for most individuals with arthritis and a functioning rotator cuff. A video is shown here.
A ream and run for individuals with arthritis who desire high levels of physical activity, including impact to the shoulder. A bit about the rational and technique is shown here, here and here. And some details of the technique are shown here.
A CTA arthroplasty for individuals with arthritis and rotator cuff deficiency, but with good shoulder stability and the ability to actively raise the arm. A two year result is shown here.
and
A reverse total shoulder for individuals with arthritis and rotator cuff deficiency and either instability or the inability to raise the arm by itself. A bit more about this procedure can be seen here and here

The rehabilitation after any shoulder replacement needs to be specified by the surgeon. Not infrequently modifications need to be made based on the details of the findings at surgery and the specifics of surgery. For total shoulders and for the ream and run we often prescribe the exercises shown in the following links
Post 1
Post 2
Post 3
Post 4

As well as this series of videos
Supine stretch
Pulley
One month
6 weeks
7 weeks
8 weeks
10 weeks
12 weeks

Some other exercises that can be considered if advised by the surgeon are shown here.

The recovery after shoulder replacement can be documented by following the simple shoulder test scores as shown here

Some patients have generously provided a diary of their recovery after the ream and run,  as shown in these links
Post A
Post B
Post C
and if you like drumming
Post D
or chopping wood
Post E
or raquetball
Post F
or kayaking
Post G
or badminton and weights
Post H
or getting 'Grandpa' back up on his slalom ski that had been put away for 7 years
Post I
or violin
Post J


After all shoulder joint replacements, we recommend antibiotics before dental and other procedures.



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