Sunday, June 1, 2014

A couple of two year followups after ream and run for advanced glenohumeral arthritis

Last week we had the opportunity of seeing two men who were over two years after a ream and run procedure, both were active men in their mid fifties.

The first had a preoperative Simple Shoulder Test score of 6 out of 12 and these x-rays, showing a severe posterior displacement - almost a complete dislocation - of the humeral head on the glenoid.

Two years later his Simple Shoulder Test score was 10. His two year followup films are shown below. Note the use of the eccentric humeral head to manage the posterior instability.

The second had a preoperative Simple Shoulder Test score of 0 out of 12 and these x-rays showing a biconcave glenoid.

At two years his Simple Shoulder Tests had improved to 12/12. His followup films are shown below.

Both individuals were participating in major physical activities and noted that their shoulder comfort and function was continuing to improve.

Comment: In both cases it is interesting to note that the extent of the preoperative pathology is only evident on the axillary view. The followup films show no evidence of glenoid wear.


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