A 50 year old male who is otherwise healthy and
leads an active lifestyle had the insidious onset of right shoulder pain,
stiffness and crepitus. Because of his young age and high activity level, he desired a ream and run procedure.
His preoperative AP and axillary xrays revealed a downsloping and retroverted glenoid with a posterior contact position of the humeral head on the glenoid.
At surgery no attempt was made to change his glenoid version or inclination; reaming was limited to that sufficient to provide a smooth, congruent glenoid surface. His postoperative films demonstrated centering of the humeral head on the reamed glenoid socket.
This case also demonstrates that the humeral canal is not a
cylinder, but in fact is oval shaped. From the AP xrays the stem appears to have extra room within the canal, while on the axillary lateral xray it has a tight
intramedullary fit. Determining the prosthetic stem diameter from the AP x-ray view may lead to selection of a too large prosthesis that will not fit safely in the canal. As demonstrated in this case impaction grafting can manage this anatomy and provide a snug fit.
Case submitted by Robert Lucas
===
Check out the new Shoulder Arthritis Book - click here.
To see the topics covered in this Blog, click here
Use the "Search" box to the right to find other topics of interest to you.
You may be interested in some of our most visited web pages including:shoulder arthritis, total shoulder, ream and run, reverse total shoulder, CTA arthroplasty, and rotator cuff surgery as well as the 'ream and run essentials'
You may be interested in some of our most visited web pages including:shoulder arthritis, total shoulder, ream and run, reverse total shoulder, CTA arthroplasty, and rotator cuff surgery as well as the 'ream and run essentials'
