Friday, December 7, 2012

Essentials of the Ream and Run


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.


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 and here. In addition, the Video Journal of Orthopaedics has produced a nice video, which can be seen here.

Some typical pre op films showing a Walch B glenoid deformity



Typical surgical appearance of the humeral head
Post operative films






Here is the common apppearance of the shoulder one week after arthroplasty

The rehabilitation after 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 of patients having this procedure.
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 a ream and run 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
or passing, serving, and hand stands
Post L
or throwing batting practice
Post M
or doing pushups and pullups and hitting a body bag
Post N


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